Provider Demographics
NPI:1912565458
Name:GREEN-DORSEY ENTERPRISES
Entity Type:Organization
Organization Name:GREEN-DORSEY ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-748-8775
Mailing Address - Street 1:5870 HIGHWAY 6 N STE 315
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1857
Mailing Address - Country:US
Mailing Address - Phone:281-849-1949
Mailing Address - Fax:832-442-3394
Practice Address - Street 1:5870 HIGHWAY 6 N STE 315
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-1857
Practice Address - Country:US
Practice Address - Phone:281-849-1949
Practice Address - Fax:832-442-3394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1699154369OtherHOME CARE