Provider Demographics
NPI:1043269913
Name:UPGRADE HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:UPGRADE HEALTHCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ETOAMA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-313-5521
Mailing Address - Street 1:4611 S MAIN ST
Mailing Address - Street 2:STE #8A
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4731
Mailing Address - Country:US
Mailing Address - Phone:281-313-5521
Mailing Address - Fax:281-313-0590
Practice Address - Street 1:4611 S MAIN ST
Practice Address - Street 2:STE #8A
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4731
Practice Address - Country:US
Practice Address - Phone:281-313-5521
Practice Address - Fax:281-313-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010225163WH0200X, 251E00000X
TX665703164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Not Answered164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
Not Answered251E00000XAgenciesHome HealthGroup - Multi-Specialty