Provider Demographics
NPI:1467166413
Name:TRIPLE G HEALTHPLUS SERVICES LLC
Entity Type:Organization
Organization Name:TRIPLE G HEALTHPLUS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BOSEDE
Authorized Official - Middle Name:
Authorized Official - Last Name:EHIOBU
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:469-923-5870
Mailing Address - Street 1:2912 N MACARTHUR BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-4489
Mailing Address - Country:US
Mailing Address - Phone:469-923-5870
Mailing Address - Fax:469-923-5880
Practice Address - Street 1:2912 N MACARTHUR BLVD STE 104
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4489
Practice Address - Country:US
Practice Address - Phone:469-923-5870
Practice Address - Fax:469-923-5880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care