Provider Demographics
NPI:1790014785
Name:CY- CREEK HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:CY- CREEK HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AZUOGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-807-1879
Mailing Address - Street 1:10610 DUKE OF YORK CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4027
Mailing Address - Country:US
Mailing Address - Phone:281-807-1879
Mailing Address - Fax:
Practice Address - Street 1:10610 DUKE OF YORK CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4027
Practice Address - Country:US
Practice Address - Phone:281-807-1879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX586468261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service