Provider Demographics
NPI:1669171591
Name:AXIS HEALTHCARE LLC
Entity type:Organization
Organization Name:AXIS HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ESEOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUMOROTI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-475-5170
Mailing Address - Street 1:7106 GOLDEN GROUNDSEL DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7106 GOLDEN GROUNDSEL DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-4342
Practice Address - Country:US
Practice Address - Phone:832-475-5170
Practice Address - Fax:385-513-2758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty