Provider Demographics
NPI:1922141514
Name:MED PLUS HEALTHCARE INC
Entity Type:Organization
Organization Name:MED PLUS HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IDARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENYONG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-980-8118
Mailing Address - Street 1:3727 GREENBRIAR DR STE 115
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3929
Mailing Address - Country:US
Mailing Address - Phone:281-980-8118
Mailing Address - Fax:281-908-8119
Practice Address - Street 1:3727 GREENBRIAR DR STE 115
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3929
Practice Address - Country:US
Practice Address - Phone:281-980-8118
Practice Address - Fax:281-908-8119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67-9263Medicare ID - Type UnspecifiedMEDICARE NUMBER