Provider Demographics
NPI:1023387859
Name:MHMR OF TEXAS CORP
Entity Type:Organization
Organization Name:MHMR OF TEXAS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:YEMU
Authorized Official - Middle Name:ROLAND
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-332-7278
Mailing Address - Street 1:10333 HARWIN DR
Mailing Address - Street 2:#322
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-1545
Mailing Address - Country:US
Mailing Address - Phone:281-578-0019
Mailing Address - Fax:888-767-6398
Practice Address - Street 1:10333 HARWIN DR
Practice Address - Street 2:#322
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-1545
Practice Address - Country:US
Practice Address - Phone:281-578-0019
Practice Address - Fax:888-767-6398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCQMedicaid
TX52Medicaid
TX46Medicaid