Provider Demographics
NPI:1023452372
Name:OPTIMUM HEALTH SERVICE
Entity type:Organization
Organization Name:OPTIMUM HEALTH SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:NELOMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-414-1411
Mailing Address - Street 1:2600 S LOOP W
Mailing Address - Street 2:SUITE 475A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2653
Mailing Address - Country:US
Mailing Address - Phone:832-414-1411
Mailing Address - Fax:281-458-8850
Practice Address - Street 1:2600 S LOOP W
Practice Address - Street 2:SUITE 475A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2653
Practice Address - Country:US
Practice Address - Phone:832-414-1411
Practice Address - Fax:281-458-8850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health