Provider Demographics
NPI:1659389633
Name:VIP HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:VIP HOME HEALTH CARE INC
Other - Org Name:VIP HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISIDORA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:LUN
Authorized Official - Phone:956-787-4800
Mailing Address - Street 1:PO BOX 836
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577
Mailing Address - Country:US
Mailing Address - Phone:956-787-4800
Mailing Address - Fax:956-787-5999
Practice Address - Street 1:200 E SAM HOUSTON
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577
Practice Address - Country:US
Practice Address - Phone:956-787-4800
Practice Address - Fax:956-787-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002770251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX458085Medicare ID - Type Unspecified