=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962258350
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PROMOTE HEALTH CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2024
-----------------------------------------------------
Last Update Date | 04/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16811 COOK LANDING DR
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77407-2617
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-261-0458
-----------------------------------------------------
Fax | 346-368-2156
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16811 COOK LANDING DR
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77407-2617
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-261-0458
-----------------------------------------------------
Fax | 346-368-2156
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | LILIAN IFEOMA MCFRED
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-261-0458
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------