Provider Demographics
NPI:1437672706
Name:KATY HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:KATY HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TARIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKWANGUDZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-401-8309
Mailing Address - Street 1:20902 TORRENCE FALLS CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-0112
Mailing Address - Country:US
Mailing Address - Phone:713-401-8309
Mailing Address - Fax:
Practice Address - Street 1:20902 TORRENCE FALLS CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-0112
Practice Address - Country:US
Practice Address - Phone:713-401-8309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX018045253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care