Provider Demographics
NPI:1326286527
Name:DYNASTY HEALTH SERVICES
Entity Type:Organization
Organization Name:DYNASTY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUNDAY
Authorized Official - Middle Name:
Authorized Official - Last Name:UMOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-397-2810
Mailing Address - Street 1:8415 E SIENNA COVE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-7370
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8415 E SIENNA COVE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-7370
Practice Address - Country:US
Practice Address - Phone:713-397-2810
Practice Address - Fax:281-242-5572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010255253Z00000X
TX186031402332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186031402Medicaid