Provider Demographics
NPI:1851666218
Name:HOLY MEDICAL MANAGEMENT SERVICES
Entity Type:Organization
Organization Name:HOLY MEDICAL MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:FASHE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:713-640-5559
Mailing Address - Street 1:6910 CHETWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-5612
Mailing Address - Country:US
Mailing Address - Phone:713-640-5559
Mailing Address - Fax:832-433-7776
Practice Address - Street 1:6910 CHETWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5612
Practice Address - Country:US
Practice Address - Phone:713-640-5559
Practice Address - Fax:832-433-7776
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MYLENIUM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No302F00000XManaged Care OrganizationsExclusive Provider Organization