1811343585 NPI number — ELEMENTS OF EXCELLENCE HEALTHCARE SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811343585 NPI number — ELEMENTS OF EXCELLENCE HEALTHCARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELEMENTS OF EXCELLENCE HEALTHCARE SERVICES
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:
1811343585
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6550 MAPLERIDGE ST
Provider Second Line Business Mailing Address:
SUITE # 216
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77081-4600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
346-571-5114
Provider Business Mailing Address Fax Number:
346-571-5140

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6550 MAPLERIDGE ST
Provider Second Line Business Practice Location Address:
SUITE # 216
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77081-4600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
346-571-5114
Provider Business Practice Location Address Fax Number:
346-571-5140
Provider Enumeration Date:
05/11/2016

Additional Information

Authorized Official

Authorized Official Last Name:
PEAVY
Authorized Official First Name:
BELANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
346-571-5114

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , 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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