Provider Demographics
NPI:1720590755
Name:DEDICATED HEALTHCARE INCORPORATED
Entity Type:Organization
Organization Name:DEDICATED HEALTHCARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HALIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-350-2573
Mailing Address - Street 1:11104 W AIRPORT BLVD STE 135
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3040
Mailing Address - Country:US
Mailing Address - Phone:832-350-2573
Mailing Address - Fax:713-636-2814
Practice Address - Street 1:11104 W AIRPORT BLVD STE 135
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3040
Practice Address - Country:US
Practice Address - Phone:832-350-2573
Practice Address - Fax:713-636-2814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-31
Last Update Date:2023-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX381444401Medicaid