Provider Demographics
NPI:1407634256
Name:FULSHEAR HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:FULSHEAR HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLABISI
Authorized Official - Middle Name:
Authorized Official - Last Name:GBOBOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-513-4200
Mailing Address - Street 1:29734 HERON VIEW LN
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77406-3048
Mailing Address - Country:US
Mailing Address - Phone:281-513-4200
Mailing Address - Fax:
Practice Address - Street 1:29734 HERON VIEW LN
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77406-3048
Practice Address - Country:US
Practice Address - Phone:281-513-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health