Provider Demographics
NPI:1740213826
Name:PEMA HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:PEMA HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:ISHOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-266-5370
Mailing Address - Street 1:6200 SAVOY DR
Mailing Address - Street 2:SUITE 731
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3300
Mailing Address - Country:US
Mailing Address - Phone:713-266-5370
Mailing Address - Fax:713-266-5539
Practice Address - Street 1:6200 SAVOY DR
Practice Address - Street 2:SUITE 731
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3300
Practice Address - Country:US
Practice Address - Phone:713-266-5370
Practice Address - Fax:713-266-5539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007132251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health