Provider Demographics
NPI:1629339742
Name:KINGSPOINT PROVIDER SERVICES CORPORATION
Entity Type:Organization
Organization Name:KINGSPOINT PROVIDER SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KWANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-275-5405
Mailing Address - Street 1:10900 KINGSPOINT RD STE 10
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-4103
Mailing Address - Country:US
Mailing Address - Phone:832-275-5405
Mailing Address - Fax:
Practice Address - Street 1:10900 KINGSPOINT RD STE 10
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-4103
Practice Address - Country:US
Practice Address - Phone:832-275-5405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care