Provider Demographics
NPI:1275168692
Name:REYNOLDS CARE ALLEGIANCE
Entity Type:Organization
Organization Name:REYNOLDS CARE ALLEGIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PREMJI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSCN
Authorized Official - Phone:713-505-7775
Mailing Address - Street 1:1314 THREE FORKS DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-4403
Mailing Address - Country:US
Mailing Address - Phone:713-505-7775
Mailing Address - Fax:713-730-3632
Practice Address - Street 1:1314 THREE FORKS DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-4403
Practice Address - Country:US
Practice Address - Phone:713-505-7775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care