Provider Demographics
NPI:1083262521
Name:FNC PEDICARE, INC
Entity Type:Organization
Organization Name:FNC PEDICARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHIDOLUE
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF NSG PRACTI
Authorized Official - Phone:281-415-8621
Mailing Address - Street 1:1510 COLONY LAKES DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4033
Mailing Address - Country:US
Mailing Address - Phone:281-415-8621
Mailing Address - Fax:281-598-2215
Practice Address - Street 1:7777 SOUTHWEST FWY STE 304
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1813
Practice Address - Country:US
Practice Address - Phone:713-270-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-28
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center