Provider Demographics
NPI:1194308288
Name:P&G SERVICES INC
Entity type:Organization
Organization Name:P&G SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-232-4706
Mailing Address - Street 1:7007 RICHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-2839
Mailing Address - Country:US
Mailing Address - Phone:214-232-4706
Mailing Address - Fax:972-224-6992
Practice Address - Street 1:7007 RICHWOOD DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-2839
Practice Address - Country:US
Practice Address - Phone:214-232-4706
Practice Address - Fax:972-224-6992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13316476Medicaid