Provider Demographics
NPI:1730449570
Name:GLOW HEALTHCARE SOLUTIONS INCORPORATED
Entity type:Organization
Organization Name:GLOW HEALTHCARE SOLUTIONS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IFEANYI
Authorized Official - Middle Name:G
Authorized Official - Last Name:EKECHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-464-3582
Mailing Address - Street 1:1400 PEREGRINE ST
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-1754
Mailing Address - Country:US
Mailing Address - Phone:469-464-3582
Mailing Address - Fax:469-464-3592
Practice Address - Street 1:1400 PEREGRINE ST
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-1754
Practice Address - Country:US
Practice Address - Phone:469-464-3582
Practice Address - Fax:469-464-3592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-28
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3405797Medicaid