Provider Demographics
NPI:1114299567
Name:ELKHART HEALTHCARE INC.
Entity Type:Organization
Organization Name:ELKHART HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:YEWANDE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ODUKOYA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:281-822-1526
Mailing Address - Street 1:7322 SOUTHWEST FWY
Mailing Address - Street 2:#1070
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2010
Mailing Address - Country:US
Mailing Address - Phone:281-822-1526
Mailing Address - Fax:281-822-1524
Practice Address - Street 1:7322 SOUTHWEST FWY
Practice Address - Street 2:#1070
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2010
Practice Address - Country:US
Practice Address - Phone:281-822-1526
Practice Address - Fax:281-822-1524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty