Provider Demographics
NPI:1053513036
Name:DOCTOR'S HOME HEALTH
Entity type:Organization
Organization Name:DOCTOR'S HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICAL
Authorized Official - Middle Name:ANITA
Authorized Official - Last Name:MARTIN MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:409-549-0968
Mailing Address - Street 1:4338 HIGHWAY 365
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-7516
Mailing Address - Country:US
Mailing Address - Phone:409-549-0968
Mailing Address - Fax:
Practice Address - Street 1:4338 HIGHWAY 365
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-7516
Practice Address - Country:US
Practice Address - Phone:409-549-0968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health