Provider Demographics
NPI:1780814822
Name:EVANGEL PHC SERVICES INC.
Entity Type:Organization
Organization Name:EVANGEL PHC SERVICES INC.
Other - Org Name:EVANGEL PROVIDER ASSISTANCE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:IROH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-923-6620
Mailing Address - Street 1:PO BOX 35447
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77235-5447
Mailing Address - Country:US
Mailing Address - Phone:713-923-6620
Mailing Address - Fax:713-921-0008
Practice Address - Street 1:6464 SAVOY DR STE 825
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3395
Practice Address - Country:US
Practice Address - Phone:713-923-6620
Practice Address - Fax:713-921-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
TX015336251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX015336OtherDADS