Provider Demographics
NPI:1740364934
Name:HARBOR ALLIANCE, INC.
Entity type:Organization
Organization Name:HARBOR ALLIANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-397-8740
Mailing Address - Street 1:4201 FM 1960 RD W
Mailing Address - Street 2:SUITE 511
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3414
Mailing Address - Country:US
Mailing Address - Phone:281-397-8740
Mailing Address - Fax:281-397-8741
Practice Address - Street 1:4201 FM 1960 RD W
Practice Address - Street 2:SUITE 511
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3414
Practice Address - Country:US
Practice Address - Phone:281-397-8740
Practice Address - Fax:281-397-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800724126332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5827660001Medicare NSC