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General NPI Number Information
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NPI Number | 1053862649
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Entity Type | Organization
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Legal Business Name | ELITE HEALTH PROVIDERS OF HOUSTON LLC
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 10/20/2016
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Provider Practice Location Address
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Address Line | 825 FAIRMONT PKWY
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City | PASADENA
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State | TX
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Zip | 77504-2805
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Country | US
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Telephone | 281-235-5948
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Fax | 281-754-4331
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Provider Business Mailing Address
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Address Line | 825 FAIRMONT PKWY
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City | PASADENA
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State | TX
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Zip | 77504-2805
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Country | US
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Telephone | 281-235-5948
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Fax | 281-754-4331
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Authorized Official
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Title or Position | PRESIDENT
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Name | NELIA P SOLEDAD
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Credential |
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Telephone | 281-235-5948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WD1100X
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Taxonomy Name | Peritoneal Dialysis Registered Nurse
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License Number | 017241
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163WH0500X
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Taxonomy Name | Hemodialysis Registered Nurse
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License Number | 017241
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License Number State | TX
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