Provider Demographics
NPI:1811209240
Name:FAVOR MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:FAVOR MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:A
Authorized Official - Last Name:IKE
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:832-245-1270
Mailing Address - Street 1:25638 CRESTON MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-7284
Mailing Address - Country:US
Mailing Address - Phone:831-245-1270
Mailing Address - Fax:
Practice Address - Street 1:25638 CRESTON MEADOW DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-7284
Practice Address - Country:US
Practice Address - Phone:831-245-1270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health