Provider Demographics
NPI:1346652641
Name:P-A HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:P-A HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:
Authorized Official - First Name:LATEAIRA
Authorized Official - Middle Name:JISHON
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:1832-882-6348
Mailing Address - Street 1:12654 ASHFORD MEADOW DR
Mailing Address - Street 2:APT B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-6257
Mailing Address - Country:US
Mailing Address - Phone:832-882-6348
Mailing Address - Fax:
Practice Address - Street 1:12654 ASHFORD MEADOW DR
Practice Address - Street 2:APT B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-6257
Practice Address - Country:US
Practice Address - Phone:832-882-6348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8580056305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization