Provider Demographics
NPI:1174578561
Name:PHOENIX FAMILY HEALTHCARE INC.
Entity type:Organization
Organization Name:PHOENIX FAMILY HEALTHCARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, BOARD OF DIRECTORS
Authorized Official - Prefix:
Authorized Official - First Name:MARIE DAISY LOU
Authorized Official - Middle Name:TORREFRANCA
Authorized Official - Last Name:ONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-525-6020
Mailing Address - Street 1:5625 CYPRESS CREEK PKWY STE 308
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4210
Mailing Address - Country:US
Mailing Address - Phone:281-525-6020
Mailing Address - Fax:281-525-6021
Practice Address - Street 1:5625 CYPRESS CREEK PKWY STE 308
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4210
Practice Address - Country:US
Practice Address - Phone:291-525-6020
Practice Address - Fax:281-525-6021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017556251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017556OtherTEXAS DEPARTMENT OF AGING AND DISABILITY
TX017556OtherTEXAS DEPARTMENT OF AGING AND DISABILITY