Provider Demographics
NPI:1093987745
Name:FELCON HEALTHCARE, INC
Entity Type:Organization
Organization Name:FELCON HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:CHUKWUEMEKA
Authorized Official - Last Name:EZEONYE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:972-353-2493
Mailing Address - Street 1:1304 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7689
Mailing Address - Country:US
Mailing Address - Phone:972-353-2493
Mailing Address - Fax:
Practice Address - Street 1:1304 PINEHURST DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-7689
Practice Address - Country:US
Practice Address - Phone:972-353-2493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization