Provider Demographics
NPI:1376583765
Name:F K BOLD HEALTHCARE, INC
Entity type:Organization
Organization Name:F K BOLD HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUGBEMISOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAOYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-782-3558
Mailing Address - Street 1:10103 FONDREN RD.
Mailing Address - Street 2:SUITE 310
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096
Mailing Address - Country:US
Mailing Address - Phone:713-782-3558
Mailing Address - Fax:713-782-3624
Practice Address - Street 1:10103 FONDREN RD.
Practice Address - Street 2:SUITE 310
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096
Practice Address - Country:US
Practice Address - Phone:713-782-3558
Practice Address - Fax:713-782-3624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX006605251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX006605OtherHCSS AGENCY LICENSE