Provider Demographics
NPI:1427198936
Name:FIANGO HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:FIANGO HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EBONG
Authorized Official - Middle Name:ALOYSIUS
Authorized Official - Last Name:TILONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-981-9264
Mailing Address - Street 1:10101 FONDREN RD
Mailing Address - Street 2:224
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4564
Mailing Address - Country:US
Mailing Address - Phone:713-981-9264
Mailing Address - Fax:713-981-9280
Practice Address - Street 1:10101 FONDREN RD
Practice Address - Street 2:224
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4564
Practice Address - Country:US
Practice Address - Phone:713-981-9264
Practice Address - Fax:713-981-9280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009356251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679188Medicare Oscar/Certification