Provider Demographics
NPI:1255572384
Name:ARENA HEALTHCARE INC.
Entity type:Organization
Organization Name:ARENA HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-261-0804
Mailing Address - Street 1:2440 TEXAS PKWY
Mailing Address - Street 2:#140
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-4000
Mailing Address - Country:US
Mailing Address - Phone:281-261-0804
Mailing Address - Fax:281-261-0836
Practice Address - Street 1:2440 TEXAS PKWY
Practice Address - Street 2:#140
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-4000
Practice Address - Country:US
Practice Address - Phone:281-261-0804
Practice Address - Fax:281-261-0836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization