Provider Demographics
NPI:1417104712
Name:PATRIOT HEALTHCARE, LLC
Entity Type:Organization
Organization Name:PATRIOT HEALTHCARE, LLC
Other - Org Name:PATIOT HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:KOEPKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-579-5662
Mailing Address - Street 1:21720 KINGSLAND BLVD.,
Mailing Address - Street 2:SUITE 301
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2513
Mailing Address - Country:US
Mailing Address - Phone:281-589-2900
Mailing Address - Fax:281-558-1395
Practice Address - Street 1:217020 KINGSLAND BLVE
Practice Address - Street 2:STE 301
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2513
Practice Address - Country:US
Practice Address - Phone:281-589-2900
Practice Address - Fax:281-558-1395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health