Provider Demographics
NPI:1942379359
Name:CONCEPT HEALTH SERVICES INC
Entity Type:Organization
Organization Name:CONCEPT HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KANAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:OBUKWELU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-701-9547
Mailing Address - Street 1:13707 SUNMOUNT PINES DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083
Mailing Address - Country:US
Mailing Address - Phone:281-701-9547
Mailing Address - Fax:281-498-1163
Practice Address - Street 1:13707 SUNMOUNT PINES DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083
Practice Address - Country:US
Practice Address - Phone:281-701-9547
Practice Address - Fax:281-498-1163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010150251E00000X
TX1017133251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188730901Medicaid
TX32017859292Medicaid