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Organization
TEXAS PHS PROFESSIONAL ASSOCIATION
Active
Organization
TEXAS PHS PROFESSIONAL ASSOCIATION
Active
Parent organization
PROVIDER HEALTH SERVICES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDER HEALTH SERVICES LLC
Authorized official
NICOLE HOWARD (CFO)
(337) 991-9276
Entity
Organization
Contact information
Practice address
800 W 5TH ST, SUITE 201, AUSTIN, TX 78703-5436
(901) 261-4858
(901) 261-4867
Mailing address
1509 DULLES DRIVE, LAFAYETTE, LA 70506
(337) 991-9276
(337) 991-9288
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/18/2010
Last updated
07/02/2014
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