Provider Demographics
NPI:1679715254
Name:KIS MED CONCEPTS, INC.
Entity Type:Organization
Organization Name:KIS MED CONCEPTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NGOZI
Authorized Official - Middle Name:I
Authorized Official - Last Name:KANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-271-8814
Mailing Address - Street 1:9543 BISSONNET, SUITE 350
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77032
Mailing Address - Country:US
Mailing Address - Phone:713-271-8814
Mailing Address - Fax:713-271-8807
Practice Address - Street 1:106 COPPER STREAM LANE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77036
Practice Address - Country:US
Practice Address - Phone:713-480-3366
Practice Address - Fax:713-271-8807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health