Provider Demographics
NPI:1407346406
Name:HEALING HANDS FAMILY CARE, PLLC
Entity Type:Organization
Organization Name:HEALING HANDS FAMILY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:INEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:201-382-8213
Mailing Address - Street 1:2159 TIMBERCREEK RD
Mailing Address - Street 2:
Mailing Address - City:PIPE CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:78063-5591
Mailing Address - Country:US
Mailing Address - Phone:210-382-8213
Mailing Address - Fax:
Practice Address - Street 1:2159 TIMBERCREEK RD
Practice Address - Street 2:
Practice Address - City:PIPE CREEK
Practice Address - State:TX
Practice Address - Zip Code:78063-5591
Practice Address - Country:US
Practice Address - Phone:210-382-8213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX583158261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1285739003Medicaid