Provider Demographics
NPI:1447576624
Name:KOZYKARE HEALTH SERVICES
Entity Type:Organization
Organization Name:KOZYKARE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MADELYN
Authorized Official - Middle Name:WALLACE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-889-4781
Mailing Address - Street 1:7010 THORNWILD RD
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-2645
Mailing Address - Country:US
Mailing Address - Phone:281-889-4781
Mailing Address - Fax:281-416-0932
Practice Address - Street 1:7010 THORNWILD RD
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-2645
Practice Address - Country:US
Practice Address - Phone:281-889-4781
Practice Address - Fax:281-416-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management