Provider Demographics
NPI:1003236324
Name:EMPOWERED CARE OF TEXAS, INC.
Entity Type:Organization
Organization Name:EMPOWERED CARE OF TEXAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HEATHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:281-900-3148
Mailing Address - Street 1:23022 LANHAM DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1423
Mailing Address - Country:US
Mailing Address - Phone:281-900-3148
Mailing Address - Fax:281-392-7432
Practice Address - Street 1:23022 LANHAM DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1423
Practice Address - Country:US
Practice Address - Phone:281-900-3148
Practice Address - Fax:281-392-7432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX646173261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care