Provider Demographics
NPI:1184395733
Name:HERSTEL CARE CORPORATION
Entity type:Organization
Organization Name:HERSTEL CARE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KEYAIRA
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:SILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-577-8595
Mailing Address - Street 1:18204 CHISHOLM TRL APT 711
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-1129
Mailing Address - Country:US
Mailing Address - Phone:619-577-8595
Mailing Address - Fax:
Practice Address - Street 1:18204 CHISHOLM TRL APT 711
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-1129
Practice Address - Country:US
Practice Address - Phone:619-577-8595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1942850904Medicaid
TX1184395733Medicaid