Healthcare Provider Details
I. General information
NPI: 1114439031
Provider Name (Legal Business Name): P&H MEDICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9034 SAGE THISTLE TRL
RICHMOND TX
77406-1550
US
IV. Provider business mailing address
9034 SAGE THISTLE TRL
RICHMOND TX
77406-1550
US
V. Phone/Fax
- Phone: 832-588-8732
- Fax:
- Phone: 832-588-8732
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 921708 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 227900000X |
| Taxonomy | Registered Respiratory Therapist |
| License Number | RCP00069945 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 227900000X |
| Taxonomy | Registered Respiratory Therapist |
| License Number | RCP00067146 |
| License Number State | TX |
VIII. Authorized Official
Name:
PATRICIA
K
ROLLINS MARTIN
Title or Position: CEO
Credential: BSN, RN
Phone: 832-588-8732