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General NPI Number Information
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NPI Number | 1346652641
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Entity Type | Organization
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Legal Business Name | P-A HEALTHCARE SERVICES
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 05/21/2014
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Provider Practice Location Address
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Address Line | 12654 ASHFORD MEADOW DR APT B
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City | HOUSTON
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State | TX
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Zip | 77082-6257
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Country | US
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Telephone | 832-882-6348
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Fax |
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Provider Business Mailing Address
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Address Line | 12654 ASHFORD MEADOW DR APT B
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City | HOUSTON
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State | TX
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Zip | 77082-6257
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Country | US
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Telephone | 832-882-6348
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Fax |
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Authorized Official
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Title or Position | CNA
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Name | LATEAIRA JISHON PARKS
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Credential | CNA
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Telephone | 18328826348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 8580056
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License Number State | TX
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