Provider Demographics
NPI:1043716376
Name:S&A HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:S&A HEALTHCARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SOHEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-620-7239
Mailing Address - Street 1:4418 BLUEBONNET DR STE 303
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-2904
Mailing Address - Country:US
Mailing Address - Phone:832-620-7239
Mailing Address - Fax:
Practice Address - Street 1:4418 BLUEBONNET DR STE 303
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2904
Practice Address - Country:US
Practice Address - Phone:832-620-7239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1002107332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1002107OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES REGULATORY LICENSING UNIT