Organization
PROVIDENCE TOTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMOTOPE ALEXANDER (ADMINISTRATOR)
(832) 857-0892
Entity
Organization
Contact information
Practice address
6201 BONHOMME RD STE 185ND, HOUSTON, TX 77036-4371
(832) 857-0892
(832) 416-1502
Mailing address
6201 BONHOMME RD STE 185ND, HOUSTON, TX 77036-4371
(832) 857-0892
(832) 416-1502
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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