Provider Demographics
NPI:1619979960
Name:PRIORITY PROFESSIONAL SERVICES, INC.
Entity Type:Organization
Organization Name:PRIORITY PROFESSIONAL SERVICES, INC.
Other - Org Name:PRIORITY HOME HEALTH SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-692-9704
Mailing Address - Street 1:12160 ABRAMS RD
Mailing Address - Street 2:SUITE 625
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4547
Mailing Address - Country:US
Mailing Address - Phone:214-692-9704
Mailing Address - Fax:214-692-6296
Practice Address - Street 1:12160 ABRAMS RD
Practice Address - Street 2:SUITE 625
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4547
Practice Address - Country:US
Practice Address - Phone:214-692-9704
Practice Address - Fax:214-692-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002355251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX002355OtherHOME HEALTH LICENSE NUMBE
677520Medicare ID - Type Unspecified