| Provider Health Services Llc | |
|
1906 Treble Dr Ste 18 Humble TX 77338-5284 | |
| (281) 305-8633 | |
| (281) 305-8633 |
| Full Name | Provider Health Services Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1906 Treble Dr Ste 18, Humble, Texas |
| Authorized Official Name and Position | Victor Mzyece (PRESIDENT) |
| Authorized Official Contact | 2813058633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Provider Health Services Llc 14511 Emma Springs Ct Humble TX 77396-4893 Ph: (281) 305-8633 | Provider Health Services Llc 1906 Treble Dr Ste 18 Humble TX 77338-5284 Ph: (281) 305-8633 |
| NPI Number | 1831967561 |
|---|---|
| Provider Enumeration Date | 12/12/2023 |
| Last Update Date | 04/02/2024 |
| Medicare PECOS PAC ID | 5092156232 |
|---|---|
| Medicare Enrollment ID | O20240517003672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831967561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Victor Mzyece |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659732345 PECOS PAC ID: 9931471042 Enrollment ID: I20240517003686 |
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