Provider Demographics
NPI:1922004944
Name:ST MARY'S HOME HEALTH INC
Entity Type:Organization
Organization Name:ST MARY'S HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMASRI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-781-4211
Mailing Address - Street 1:5300 HOLLISTER RD.
Mailing Address - Street 2:STE 500
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-6138
Mailing Address - Country:US
Mailing Address - Phone:713-781-4211
Mailing Address - Fax:713-781-4221
Practice Address - Street 1:5300 HOLLISTER RD
Practice Address - Street 2:STE 500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-6138
Practice Address - Country:US
Practice Address - Phone:713-781-4211
Practice Address - Fax:713-781-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007453251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX459442Medicare Oscar/Certification