Provider Demographics
NPI:1174284335
Name:COLTON HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:COLTON HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHIDINMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONUIGBO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:713-300-4663
Mailing Address - Street 1:703 BOLD RULER DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-6356
Mailing Address - Country:US
Mailing Address - Phone:281-777-9442
Mailing Address - Fax:
Practice Address - Street 1:703 BOLD RULER DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-6356
Practice Address - Country:US
Practice Address - Phone:713-300-4663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No251E00000XAgenciesHome Health