Provider Demographics
NPI:1396134086
Name:ENTERAL & VASCULAR HEALTH MANAGEMENT LLC
Entity type:Organization
Organization Name:ENTERAL & VASCULAR HEALTH MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:832-491-3052
Mailing Address - Street 1:1200 SMITH ST
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-4313
Mailing Address - Country:US
Mailing Address - Phone:832-491-3052
Mailing Address - Fax:
Practice Address - Street 1:1200 SMITH ST
Practice Address - Street 2:SUITE 1600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-4313
Practice Address - Country:US
Practice Address - Phone:832-491-3052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-18
Last Update Date:2015-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124325251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health