Provider Demographics
NPI:1619611746
Name:PROVIDERS RESOURCES OF TEXAS, LLC
Entity Type:Organization
Organization Name:PROVIDERS RESOURCES OF TEXAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:R
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-400-1599
Mailing Address - Street 1:2001 TIMBERLOCH PLACE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380
Mailing Address - Country:US
Mailing Address - Phone:281-335-6487
Mailing Address - Fax:
Practice Address - Street 1:2001 TIMBERLOCH PL STE 500
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1375
Practice Address - Country:US
Practice Address - Phone:281-335-6487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management