Provider Demographics
NPI:1417284001
Name:SPARKS HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:SPARKS HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/ADMINISTRATOR/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YEWANDE
Authorized Official - Middle Name:ABIOLA
Authorized Official - Last Name:OGUNYEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-223-4733
Mailing Address - Street 1:236 BRICKNELL LN
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2597
Mailing Address - Country:US
Mailing Address - Phone:214-223-4733
Mailing Address - Fax:
Practice Address - Street 1:236 BRICKNELL LN
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2597
Practice Address - Country:US
Practice Address - Phone:214-223-4733
Practice Address - Fax:972-471-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX705172251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care