Provider Demographics
NPI:1619249729
Name:PROCARE MEDICAL SERVICES
Entity Type:Organization
Organization Name:PROCARE MEDICAL SERVICES
Other - Org Name:EMAIDO E. HAILEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EMAIDO
Authorized Official - Middle Name:ETUKUDOH
Authorized Official - Last Name:HAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-903-7474
Mailing Address - Street 1:10701 CORPORATE DR
Mailing Address - Street 2:193
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4096
Mailing Address - Country:US
Mailing Address - Phone:281-903-7474
Mailing Address - Fax:832-500-4095
Practice Address - Street 1:10701 CORPORATE DR
Practice Address - Street 2:193
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4096
Practice Address - Country:US
Practice Address - Phone:281-903-7474
Practice Address - Fax:832-500-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-04
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX014831251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health