1063778801 NPI number — ANGELS GATE HOME HEALTH CARE LLC

Table of content: DR. JAMES F. ROSENWALD DDS (NPI 1093729899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063778801 NPI number — ANGELS GATE HOME HEALTH CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANGELS GATE HOME HEALTH CARE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063778801
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13644 BRETON RIDGE DR STE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77070-6087
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-970-2978
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13644 BRETON RIDGE DR STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77070-6087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-970-2978
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/05/2012

Additional Information

Authorized Official

Authorized Official Last Name:
HEILERS
Authorized Official First Name:
MELANIE
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
ADMINISTRATOR/DON
Authorized Official Telephone Number:
832-628-5096

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  656911 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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