Provider Demographics
NPI:1699843276
Name:SEFAN HEALTHCARE SERVICES INC,
Entity Type:Organization
Organization Name:SEFAN HEALTHCARE SERVICES INC,
Other - Org Name:SEFAN MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATE
Authorized Official - Middle Name:O
Authorized Official - Last Name:OLEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-541-2588
Mailing Address - Street 1:9894 BISSONNET ST
Mailing Address - Street 2:SUITE,770
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8239
Mailing Address - Country:US
Mailing Address - Phone:713-541-2588
Mailing Address - Fax:713-541-4435
Practice Address - Street 1:9894 BISSONNET ST
Practice Address - Street 2:SUITE 770
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8239
Practice Address - Country:US
Practice Address - Phone:713-541-2588
Practice Address - Fax:713-541-4435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0084511332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5595330001Medicare NSC