Provider Demographics
NPI:1891018529
Name:SPLENDOR CARE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:SPLENDOR CARE HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SYLVESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:IYAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-696-1803
Mailing Address - Street 1:1001 W EULESS BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-5034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 W EULESS BLVD STE 405
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-5034
Practice Address - Country:US
Practice Address - Phone:817-675-8088
Practice Address - Fax:817-479-9827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX343361702Medicaid