Provider Demographics
NPI:1306138771
Name:PCDG ENTERPRISES LLC
Entity type:Organization
Organization Name:PCDG ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:LINDSEY
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:281-606-4335
Mailing Address - Street 1:150 W SHADOWBEND AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3968
Mailing Address - Country:US
Mailing Address - Phone:281-606-4335
Mailing Address - Fax:281-606-4337
Practice Address - Street 1:150 W SHADOWBEND AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3968
Practice Address - Country:US
Practice Address - Phone:281-606-4335
Practice Address - Fax:281-606-4337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX014278251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX014278OtherDADS TEXAS