Provider Demographics
NPI:1740640259
Name:BERNADETTE FIELDS HEALTHCARE, LLC
Entity type:Organization
Organization Name:BERNADETTE FIELDS HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-438-8022
Mailing Address - Street 1:2200 BUSINESS CENTER DR
Mailing Address - Street 2:11109
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1359
Mailing Address - Country:US
Mailing Address - Phone:713-438-8022
Mailing Address - Fax:
Practice Address - Street 1:2200 BUSINESS CENTER DR
Practice Address - Street 2:11109
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1359
Practice Address - Country:US
Practice Address - Phone:713-438-8022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017289311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility