Provider Demographics
NPI:1376854299
Name:PREMIER HEALTH SERVICES COMPANY,LLC
Entity Type:Organization
Organization Name:PREMIER HEALTH SERVICES COMPANY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-652-0025
Mailing Address - Street 1:11720 W AIRPORT BLVD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:MEADOWS PLACE
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3060
Mailing Address - Country:US
Mailing Address - Phone:832-924-6650
Mailing Address - Fax:832-924-6651
Practice Address - Street 1:11720 W AIRPORT BLVD
Practice Address - Street 2:SUITE 800
Practice Address - City:MEADOWS PLACE
Practice Address - State:TX
Practice Address - Zip Code:77477-3060
Practice Address - Country:US
Practice Address - Phone:832-924-6650
Practice Address - Fax:832-924-6651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D2007761OtherCLIA