| 106bh Llc | |
|
1034 Regional Park Dr Houston TX 77060-1117 | |
| (346) 842-0424 | |
| Not Available |
| Full Name | 106bh Llc |
|---|---|
| Speciality | Case Management |
| Location | 1034 Regional Park Dr, Houston, Texas |
| Authorized Official Name and Position | Jon Nathan Ford (MANAGER) |
| Authorized Official Contact | 3468420424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 106bh Llc 1034 Regional Park Dr Houston TX 77060-1117 Ph: () - | 106bh Llc 1034 Regional Park Dr Houston TX 77060-1117 Ph: (346) 842-0424 |
| NPI Number | 1972384469 |
|---|---|
| Provider Enumeration Date | 10/10/2023 |
| Last Update Date | 10/10/2023 |
| Certification Date | 10/10/2023 |
| Medicare PECOS PAC ID | 7911340120 |
|---|---|
| Medicare Enrollment ID | O20240205002451 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972384469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
| Provider Name | Stacey Rawls |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043249774 PECOS PAC ID: 6901903327 Enrollment ID: I20160111000649 |
| Provider Name | Miles S Raizada |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548671688 PECOS PAC ID: 6901109024 Enrollment ID: I20160125001042 |
| Provider Name | Bhavjeet Khara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568082519 PECOS PAC ID: 9335559582 Enrollment ID: I20201029002258 |
| Provider Name | Letitia Powell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295911436 PECOS PAC ID: 0345786687 Enrollment ID: I20240805001583 |
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