Provider Demographics
NPI:1497002455
Name:OMON HOME HEALTH, INC
Entity Type:Organization
Organization Name:OMON HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE, BSN
Authorized Official - Prefix:
Authorized Official - First Name:IZEHIESE
Authorized Official - Middle Name:IMUWAHEN
Authorized Official - Last Name:OBANOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-437-1132
Mailing Address - Street 1:2419 FAIRBREEZE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5103
Mailing Address - Country:US
Mailing Address - Phone:832-437-1132
Mailing Address - Fax:
Practice Address - Street 1:2419 FAIRBREEZE DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5103
Practice Address - Country:US
Practice Address - Phone:832-437-1132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX797980251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health