Provider Demographics
NPI:1376049650
Name:MSOMI, FIKILE
Entity Type:Individual
Prefix:
First Name:FIKILE
Middle Name:
Last Name:MSOMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NOAH ARK UNITED HOME
Other - Middle Name:CARE,
Other - Last Name:LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NOAH ARK UNITED HOME
Mailing Address - Street 1:2127 BEACON PARK CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-2586
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2127 BEACON PARK CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-2586
Practice Address - Country:US
Practice Address - Phone:929-990-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide