Provider Demographics
NPI:1043892706
Name:CK TEXAS HOLDINGS INC.
Entity Type:Organization
Organization Name:CK TEXAS HOLDINGS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:VAN DUINEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-560-8085
Mailing Address - Street 1:8205 CAMP BOWIE WEST BLVD STE 216
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-6328
Mailing Address - Country:US
Mailing Address - Phone:817-560-8085
Mailing Address - Fax:817-560-7760
Practice Address - Street 1:8205 CAMP BOWIE WEST BLVD STE 216
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-6328
Practice Address - Country:US
Practice Address - Phone:817-560-8085
Practice Address - Fax:817-560-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care