Provider Demographics
NPI:1467641019
Name:ALL- MODREN HEALTH CARE,INC
Entity Type:Organization
Organization Name:ALL- MODREN HEALTH CARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:UZOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-377-8764
Mailing Address - Street 1:2600 S LOOP W STE 105
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2603
Mailing Address - Country:US
Mailing Address - Phone:713-658-1000
Mailing Address - Fax:713-777-7575
Practice Address - Street 1:2600 S LOOP W STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2603
Practice Address - Country:US
Practice Address - Phone:713-658-1000
Practice Address - Fax:713-777-7575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX677870251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677870Medicare Oscar/Certification