Provider Demographics
NPI:1134369788
Name:MEDHEALTH HOUSECALLS INCORPORATED
Entity type:Organization
Organization Name:MEDHEALTH HOUSECALLS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMONET
Authorized Official - Middle Name:BLANDO
Authorized Official - Last Name:ABULOC
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MSN,FNP
Authorized Official - Phone:214-714-0117
Mailing Address - Street 1:2605 CHESAPEAKE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-0901
Mailing Address - Country:US
Mailing Address - Phone:214-714-0117
Mailing Address - Fax:
Practice Address - Street 1:2605 CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-0901
Practice Address - Country:US
Practice Address - Phone:214-714-0117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontologyGroup - Multi-Specialty