Provider Demographics
NPI:1649065038
Name:PETRA HOME CARE AND HOSPICE INC.
Entity type:Organization
Organization Name:PETRA HOME CARE AND HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHOWUNMI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-320-9619
Mailing Address - Street 1:4518 KNIGHT LAKE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-7982
Mailing Address - Country:US
Mailing Address - Phone:713-320-9619
Mailing Address - Fax:713-513-5279
Practice Address - Street 1:16305 WESTHEIMER RD STE 104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-1245
Practice Address - Country:US
Practice Address - Phone:713-320-9619
Practice Address - Fax:713-513-5279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care