Provider Demographics
NPI:1851566624
Name:TH LIVINGTREE OF TEXAS
Entity Type:Organization
Organization Name:TH LIVINGTREE OF TEXAS
Other - Org Name:MEDSTAT MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-429-3631
Mailing Address - Street 1:12623 BETHANY BAY DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7867
Mailing Address - Country:US
Mailing Address - Phone:713-429-3631
Mailing Address - Fax:866-466-4320
Practice Address - Street 1:13602 HIRAM CLARKE RD
Practice Address - Street 2:SUITE C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045-4349
Practice Address - Country:US
Practice Address - Phone:713-429-3631
Practice Address - Fax:866-466-4320
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIVINGTREE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies