Provider Demographics
NPI:1801304316
Name:HEALTH VANTAGE INC
Entity type:Organization
Organization Name:HEALTH VANTAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DERA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-674-9566
Mailing Address - Street 1:6411 BRIAR MOSS
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449
Mailing Address - Country:US
Mailing Address - Phone:832-674-9566
Mailing Address - Fax:713-774-8282
Practice Address - Street 1:6411 BRIAR MOSS
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449
Practice Address - Country:US
Practice Address - Phone:832-674-9566
Practice Address - Fax:713-774-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health