PROVIDIAN HEALTH CARE INC.
Agencies at Gulf Fwy, Houston, TX

License number
Texas 010276
Category
Agencies
Type
Home Health
Owner
Name: MR. KEN RAY KOEPKE
Title: ADMINISTRATOR/CEO
Phone: (713) 490-3500
Address
Address
12929 Gulf Fwy SUITE 101, Houston, TX 77034
National Provider ID: 1063460483
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about PROVIDIAN HEALTH CARE INC. at bizstanding.com

Providian Health Care, Inc

Houston, TX

Doing business as:
Providian Health Care, Inc<br>Providian Health Care
Registration:
Jan 8, 2004
Phone:
(713) 490-3500 (Phone)
Addresses:
2000 S Dairy Ashford St, Houston, TX 77077
12929 Gulf Fwy, Houston, TX 77034
8866 Gulf Fwy, Houston, TX 77017
State ID:
0800290234
Business type:
Domestic For-Profit Corporation
Owners:
Ken Koepke (Director, Principal, Administration, Chief Executive Officer),Michael A. Truelock Owner, inactive
Agent:
Justin Perryman,2000 S Dairy Ashford, Houston, TX 77077 (Physical)
TIN:
15826827113

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