Provider Demographics
NPI:1912209016
Name:TEXAS PEDIATRIC HOME HEALTH LLC
Entity Type:Organization
Organization Name:TEXAS PEDIATRIC HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:DELA ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-788-3334
Mailing Address - Street 1:15734 RIDGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2647
Mailing Address - Country:US
Mailing Address - Phone:713-446-6585
Mailing Address - Fax:866-317-2640
Practice Address - Street 1:15734 RIDGE PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2647
Practice Address - Country:US
Practice Address - Phone:713-446-6585
Practice Address - Fax:866-317-2640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion