Provider Demographics
NPI:1811343585
Name:ELEMENTS OF EXCELLENCE HEALTHCARE SERVICES
Entity type:Organization
Organization Name:ELEMENTS OF EXCELLENCE HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEAVY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:346-571-5114
Mailing Address - Street 1:6550 MAPLERIDGE ST
Mailing Address - Street 2:SUITE # 216
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-4600
Mailing Address - Country:US
Mailing Address - Phone:346-571-5114
Mailing Address - Fax:346-571-5140
Practice Address - Street 1:6550 MAPLERIDGE ST
Practice Address - Street 2:SUITE # 216
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4600
Practice Address - Country:US
Practice Address - Phone:346-571-5114
Practice Address - Fax:346-571-5140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care