Provider Demographics
NPI:1952893380
Name:PREFERRED HEALTHCARE GROUP LLC
Entity Type:Organization
Organization Name:PREFERRED HEALTHCARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MBAKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-909-5220
Mailing Address - Street 1:5959 WESTHEIMER RD STE 425
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7699
Mailing Address - Country:US
Mailing Address - Phone:713-360-7773
Mailing Address - Fax:713-360-7774
Practice Address - Street 1:8710 STOWE CREEK LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459
Practice Address - Country:US
Practice Address - Phone:713-909-5220
Practice Address - Fax:281-754-4552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-01
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YA0400X, 251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health