Providence Care Health Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

14926 Issued in TX

Legal business name

PROVIDENCE CARE HEALTH SERVICES, INC.

Practice address

1269 N Main St
Vidor, TX 77662-3740

Phone

(409) 813-2273

Fax

(409) 813-2272

NPI assigned

Jun 14, 2005

Last updated

May 4, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth Ann Watts, DO

Title

Administrator

Phone

(409) 813-2273

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525392000000",
    "number": "1962407247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1269 N MAIN ST",
            "city": "VIDOR",
            "state": "TX",
            "postal_code": "776623740",
            "telephone_number": "409-813-2273",
            "fax_number": "409-813-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1269 N MAIN ST",
            "city": "VIDOR",
            "state": "TX",
            "postal_code": "776623740",
            "telephone_number": "409-813-2273",
            "fax_number": "409-813-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE CARE HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2018-05-04",
        "status": "A",
        "authorized_official_last_name": "WATTS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "409-813-2273",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "009147",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "14926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Vidor, TX
• Providers in Vidor, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.