Provider Demographics
NPI:1285602656
Name:HIGH ISLAND MERCY CORPS INC
Entity type:Organization
Organization Name:HIGH ISLAND MERCY CORPS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:ISAACKS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:409-286-5811
Mailing Address - Street 1:PO BOX 691363
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-1363
Mailing Address - Country:US
Mailing Address - Phone:281-397-0397
Mailing Address - Fax:281-397-6934
Practice Address - Street 1:2144 7TH STREET
Practice Address - Street 2:
Practice Address - City:HIGH ISLAND
Practice Address - State:TX
Practice Address - Zip Code:77623
Practice Address - Country:US
Practice Address - Phone:409-286-5811
Practice Address - Fax:409-286-5424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088241701Medicaid
LA1630411Medicaid
590014682OtherRAILROAD MEDICARE
TX088241701Medicaid
G41943Medicare UPIN