Provider Demographics
NPI:1295264968
Name:FIDELIA MEDICAL SERVICES
Entity type:Organization
Organization Name:FIDELIA MEDICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHINEDU
Authorized Official - Last Name:NDUBUISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-417-4402
Mailing Address - Street 1:1518 GLACIER BLUE DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-9526
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1518 GLACIER BLUE DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-9526
Practice Address - Country:US
Practice Address - Phone:713-417-4402
Practice Address - Fax:281-972-9432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle