Provider Demographics
NPI:1982657565
Name:DEAVRA ARPEGE DAUGHTRY
Entity Type:Organization
Organization Name:DEAVRA ARPEGE DAUGHTRY
Other - Org Name:EXCEL-E-CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEAVRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUGHTRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-697-9235
Mailing Address - Street 1:9516 NORTH FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77037-1441
Mailing Address - Country:US
Mailing Address - Phone:713-697-9235
Mailing Address - Fax:713-697-9406
Practice Address - Street 1:9516 NORTH FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77037-1441
Practice Address - Country:US
Practice Address - Phone:713-697-9235
Practice Address - Fax:713-697-9406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005652251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185369901Medicaid
TX185576901Medicaid
TX1003624Medicare UPIN
TX001013348Medicare UPIN
TX1003621Medicare UPIN
TX000107300Medicare UPIN
TX185369901Medicaid
TX185576901Medicaid
TX1003625Medicare UPIN