Provider Demographics
NPI:1326782905
Name:IMMEKA GROUP LLC
Entity Type:Organization
Organization Name:IMMEKA GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:JULIETH
Authorized Official - Last Name:MREMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-791-4805
Mailing Address - Street 1:11200 WESTHEIMER RD STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3229
Mailing Address - Country:US
Mailing Address - Phone:832-257-9457
Mailing Address - Fax:
Practice Address - Street 1:11200 WESTHEIMER RD STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3229
Practice Address - Country:US
Practice Address - Phone:832-257-9457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No342000000XTransportation ServicesTransportation Network CompanyGroup - Single Specialty
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX872428783Medicaid