Provider Demographics
NPI:1982659488
Name:VICTORIAN HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:VICTORIAN HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRTATOR
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BESONG-ESIM
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:281-302-6680
Mailing Address - Street 1:3502 STRATFORD MANOR DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-4609
Mailing Address - Country:US
Mailing Address - Phone:281-302-6680
Mailing Address - Fax:346-707-3616
Practice Address - Street 1:3502 STRATFORD MANOR DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-4609
Practice Address - Country:US
Practice Address - Phone:281-903-7882
Practice Address - Fax:346-707-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679615Medicare Oscar/Certification