1124050349 NPI number — HONOR SERVICES,INC.

Table of content: (NPI 1124050349)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124050349 NPI number — HONOR SERVICES,INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HONOR SERVICES,INC.
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:
PALO DURO NURSING AND REHABILITATION
Provider Other Organization Name Type Code:
3
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:
1124050349
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4202 19TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79407-2405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-771-4127
Provider Business Mailing Address Fax Number:
806-771-4126

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1931 MEDI PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMARILLO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79106-2182
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-352-5600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/07/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JEWEL
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
806-771-4124

Provider Taxonomy Codes

  • Taxonomy code: 313M00000X , 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)