Provider Demographics
NPI:1164451811
Name:K & G QUALITY HEALTHCARE SERVICE
Entity Type:Organization
Organization Name:K & G QUALITY HEALTHCARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALT. ADMINISTRATOR/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:IJEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-313-1844
Mailing Address - Street 1:12603 SOUTHWEST FWY STE 520
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3818
Mailing Address - Country:US
Mailing Address - Phone:281-313-1844
Mailing Address - Fax:281-313-1848
Practice Address - Street 1:12603 SOUTHWEST FWY STE 520
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3818
Practice Address - Country:US
Practice Address - Phone:281-313-1844
Practice Address - Fax:281-313-1848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEIN NUMBER
TX=========OtherEIN NUMBER