Provider Demographics
NPI:1366010175
Name:AMENITY HEALTH SERVICES PLLC
Entity Type:Organization
Organization Name:AMENITY HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-508-9609
Mailing Address - Street 1:4606 FM 1960 RD W STE 520
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19255 PARK ROW STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7310
Practice Address - Country:US
Practice Address - Phone:346-333-2794
Practice Address - Fax:832-404-2649
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMENITY HEALTH SERVICES, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-16
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4009672Medicaid