Provider Demographics
NPI:1437196326
Name:BERRY HEALTHCARE SERVICES, LP
Entity Type:Organization
Organization Name:BERRY HEALTHCARE SERVICES, LP
Other - Org Name:BERRY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-344-1301
Mailing Address - Street 1:5868 WESTHEIMER RD
Mailing Address - Street 2:#431
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5641
Mailing Address - Country:US
Mailing Address - Phone:713-344-1301
Mailing Address - Fax:713-344-0156
Practice Address - Street 1:2400 AUGUSTA DR # 326
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4922
Practice Address - Country:US
Practice Address - Phone:713-344-1301
Practice Address - Fax:713-344-0156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177081001Medicaid
TX177081002Medicaid
TX177081001Medicaid