Provider Demographics
NPI:1932292265
Name:BROAD HEALTH TEXAS INTERNATIONAL
Entity Type:Organization
Organization Name:BROAD HEALTH TEXAS INTERNATIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:MU
Authorized Official - Middle Name:QING
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-933-3687
Mailing Address - Street 1:11737 LOGAN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-5673
Mailing Address - Country:US
Mailing Address - Phone:281-933-3687
Mailing Address - Fax:281-933-3680
Practice Address - Street 1:11737 LOGAN RIDGE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-5673
Practice Address - Country:US
Practice Address - Phone:281-933-3687
Practice Address - Fax:281-933-3680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX715872251E00000X, 251F00000X, 251J00000X
TX23748302332U00000X, 343900000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251F00000XAgenciesHome Infusion
Not Answered251J00000XAgenciesNursing Care
Not Answered332U00000XSuppliersHome Delivered Meals
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Not Answered347C00000XTransportation ServicesPrivate Vehicle