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Organization
PROVIDENCE CARE HEALTH SERVICES, INC.
Active
Organization
PROVIDENCE CARE HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH ANN WATTS DO (ADMINISTRATOR)
(409) 813-2273
Entity
Organization
Contact information
Practice address
1269 N MAIN ST, VIDOR, TX 77662-3740
(409) 813-2273
(409) 813-2272
Mailing address
1269 N MAIN ST, VIDOR, TX 77662-3740
(409) 813-2273
(409) 813-2272
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
009147
TX
251E00000X
Home Health Agency
Primary
14926
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172498101
—
TX
Enumeration date
06/14/2005
Last updated
05/04/2018
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