Provider Demographics
NPI:1679331177
Name:SPEKKS HEALTHCARE SERVICES PLLC
Entity Type:Organization
Organization Name:SPEKKS HEALTHCARE SERVICES PLLC
Other - Org Name:SPEKKS HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ESELE
Authorized Official - Last Name:IYOHA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:817-736-0400
Mailing Address - Street 1:1002 THICKET DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5728
Mailing Address - Country:US
Mailing Address - Phone:817-736-0400
Mailing Address - Fax:
Practice Address - Street 1:1002 THICKET DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5728
Practice Address - Country:US
Practice Address - Phone:817-736-0400
Practice Address - Fax:817-225-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty