Provider Demographics
NPI:1942757182
Name:GUIDING ANGELS
Entity Type:Organization
Organization Name:GUIDING ANGELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:EZIMAKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-212-1108
Mailing Address - Street 1:1205 WATER SPANIEL WAY
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-3414
Mailing Address - Country:US
Mailing Address - Phone:512-212-1108
Mailing Address - Fax:512-212-1168
Practice Address - Street 1:1205 WATER SPANIEL WAY
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3414
Practice Address - Country:US
Practice Address - Phone:512-212-1108
Practice Address - Fax:512-212-1168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017038251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health