Provider Demographics
NPI: | 1033620349 |
---|---|
Name: | F PLANET HEALTHCARE |
Entity Type: | Organization |
Organization Name: | F PLANET HEALTHCARE |
Other - Org Name: | F PLANET HEALTHCARE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | OLUWADARE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FADURI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 646-753-4924 |
Mailing Address - Street 1: | 21318 MYSTIC OAK DR |
Mailing Address - Street 2: | |
Mailing Address - City: | CYPRESS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77433-6750 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 646-753-4924 |
Mailing Address - Fax: | 844-358-1424 |
Practice Address - Street 1: | 21318 MYSTIC OAK DR |
Practice Address - Street 2: | |
Practice Address - City: | CYPRESS |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77433-6750 |
Practice Address - Country: | US |
Practice Address - Phone: | 646-753-4924 |
Practice Address - Fax: | 844-358-1424 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-10-14 |
Last Update Date: | 2018-06-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 018277 | 253Z00000X |
253Z00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 253Z00000X | Agencies | In Home Supportive Care |