Provider Demographics
NPI:1275910044
Name:SANDRA CORNELIUS HCS
Entity Type:Organization
Organization Name:SANDRA CORNELIUS HCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNELIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-748-2122
Mailing Address - Street 1:PO BOX 300809
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77230-0809
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:713-748-2122
Practice Address - Street 1:2804 HOLLY HALL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4129
Practice Address - Country:US
Practice Address - Phone:713-748-2122
Practice Address - Fax:713-748-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health