Provider Demographics
NPI:1417701103
Name:BACK 2 SCHOOL HEALTHCARE LLC
Entity Type:Organization
Organization Name:BACK 2 SCHOOL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:NAZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:IFTEKHAR
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:832-931-8887
Mailing Address - Street 1:12 GREENWAY PLZ STE 101
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-1208
Mailing Address - Country:US
Mailing Address - Phone:832-931-8887
Mailing Address - Fax:
Practice Address - Street 1:12 GREENWAY PLZ STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77046-1208
Practice Address - Country:US
Practice Address - Phone:832-931-8887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty