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General NPI Number Information
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NPI Number | 1295535060
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Entity Type | Organization
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Legal Business Name | PETRA HOME HEALTH AND HOSPICE SERVICES
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 4518 KNIGHT LAKE CT
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City | RICHMOND
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State | TX
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Zip | 77406-7982
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Country | US
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Telephone | 713-320-9619
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Fax | 713-513-5279
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Provider Business Mailing Address
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Address Line | 4518 KNIGHT LAKE CT
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City | RICHMOND
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State | TX
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Zip | 77406-7982
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Country | US
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Telephone | 713-320-9619
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Fax | 713-513-5279
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Authorized Official
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Title or Position | ADMIN
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Name | VICTORIA A SHOWUNMI
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Credential | RN
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Telephone | 631-741-0795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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