Provider Demographics
NPI:1487180329
Name:K/E MEDENS THERAPEUTIC SOLUTIONS, LLC
Entity Type:Organization
Organization Name:K/E MEDENS THERAPEUTIC SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KINGSLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:UMEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-224-7532
Mailing Address - Street 1:8901 TEHAMA RIDGE PKWY
Mailing Address - Street 2:SUITE 127-122
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-2031
Mailing Address - Country:US
Mailing Address - Phone:469-224-7532
Mailing Address - Fax:
Practice Address - Street 1:9625 YERBA MANSA LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-2027
Practice Address - Country:US
Practice Address - Phone:469-224-7532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health