Provider Demographics
NPI:1255578464
Name:A&T MULTI-HEALTHCARE LLC
Entity type:Organization
Organization Name:A&T MULTI-HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMAH
Authorized Official - Middle Name:MOSES
Authorized Official - Last Name:FOMUNYOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-723-0425
Mailing Address - Street 1:7923 CHANCEL DR STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-3235
Mailing Address - Country:US
Mailing Address - Phone:713-723-0425
Mailing Address - Fax:713-728-9224
Practice Address - Street 1:7923 CHANCEL DR STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-3235
Practice Address - Country:US
Practice Address - Phone:713-723-0425
Practice Address - Fax:713-728-9224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012085251E00000X
251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTPI # 191022601Medicaid
TX676933Medicare Oscar/Certification