Provider Demographics
NPI:1972803914
Name:ANGELS WITH WINGS, LLC
Entity Type:Organization
Organization Name:ANGELS WITH WINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:COOPER
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-725-0764
Mailing Address - Street 1:11026 CARVEL LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-3035
Mailing Address - Country:US
Mailing Address - Phone:832-725-0764
Mailing Address - Fax:281-988-9169
Practice Address - Street 1:11026 CARVEL LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-3035
Practice Address - Country:US
Practice Address - Phone:832-725-0764
Practice Address - Fax:281-988-9169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization