Provider Demographics
NPI:1396866299
Name:PORCHLIGHT HEALTHCARE INC
Entity Type:Organization
Organization Name:PORCHLIGHT HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUOK
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CALA
Authorized Official - Phone:832-453-7687
Mailing Address - Street 1:14714 JADE GLEN CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-1052
Mailing Address - Country:US
Mailing Address - Phone:832-453-7687
Mailing Address - Fax:
Practice Address - Street 1:8300 BISSONNET ST
Practice Address - Street 2:SUITE 222
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-3900
Practice Address - Country:US
Practice Address - Phone:832-453-7687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID