Providence Care Health Services, Inc.
Organization Active NPI Home Health Agency · Vidor, TX
NPI 1962407247 · NPPES record last updated May 4, 2018
Key facts
- NPI
- 1962407247
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 14926 (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
- Organization subpart
- No
Authorized official
- Name
- Elizabeth Ann Watts, DO
- Title
- Administrator
- Phone
- (409) 813-2273
National Provider Directory
Locations
1269 N Main St
Vidor, TX 77662
Phone (409) 962-0041
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 009147 | TX | |
| Home Health Agency | 251E00000X | 14926 | TX | Yes |
Addresses
Primary practice location
1269 N Main St
Vidor, TX 77662-3740
Mailing address
1269 N Main St
Vidor, TX 77662-3740
Phone (409) 813-2273
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 172498101 | Medicaid | TX |
Other providers in Vidor, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.