Provider Demographics
NPI:1760560742
Name:LILIES & BRAMBLES, INC
Entity Type:Organization
Organization Name:LILIES & BRAMBLES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:OPUTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-271-7778
Mailing Address - Street 1:10103 FONDREN RD
Mailing Address - Street 2:SUITE 321
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4556
Mailing Address - Country:US
Mailing Address - Phone:713-271-7778
Mailing Address - Fax:713-271-7773
Practice Address - Street 1:10103 FONDREN RD
Practice Address - Street 2:SUITE 321
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4556
Practice Address - Country:US
Practice Address - Phone:713-271-7778
Practice Address - Fax:713-271-7773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009216251E00000X
TX10006603416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153632802Medicaid
TX153632802Medicaid