Provider Demographics
NPI:1992106694
Name:FUSION ONE INC
Entity type:Organization
Organization Name:FUSION ONE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNDEINDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-670-6163
Mailing Address - Street 1:14601 BELLAIRE BLVD STE 152
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-2505
Mailing Address - Country:US
Mailing Address - Phone:281-712-2273
Mailing Address - Fax:281-712-2274
Practice Address - Street 1:14601 BELLAIRE BLVD STE 152
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-2505
Practice Address - Country:US
Practice Address - Phone:281-712-2273
Practice Address - Fax:281-712-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001027881Medicaid