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Organization
PORT HOMECARE SERVICES, INC.
Active
Organization
PORT HOMECARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MARTINEZ (PRESIDENT, ADMINISTRATOR,CEO/CFO)
(361) 854-2273
Entity
Organization
Contact information
Practice address
5525 S STAPLES ST STE A7, CORPUS CHRISTI, TX 78411-5359
(361) 854-2273
(361) 854-6419
Mailing address
5525 S STAPLES ST STE A7, CORPUS CHRISTI, TX 78411-5359
(361) 854-2273
(361) 854-6419
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
005247
TX
251E00000X
Home Health Agency
Primary
012597
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02432201
—
TX
05
—
024322201
—
TX
Enumeration date
05/27/2005
Last updated
11/08/2018
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