Provider Demographics
NPI:1427064104
Name:PROMEDIC HEALTHCARE SYSTEMS INC
Entity type:Organization
Organization Name:PROMEDIC HEALTHCARE SYSTEMS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-245-3635
Mailing Address - Street 1:857 TRISTAR DR
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-1553
Mailing Address - Country:US
Mailing Address - Phone:713-747-4400
Mailing Address - Fax:713-747-4407
Practice Address - Street 1:857 TRISTAR DR
Practice Address - Street 2:SUITE A-1
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598
Practice Address - Country:US
Practice Address - Phone:281-786-4220
Practice Address - Fax:281-786-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677973Medicare Oscar/Certification