Provider Demographics
NPI:1669983326
Name:ECA AMENITY MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:ECA AMENITY MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:OBIORA
Authorized Official - Last Name:ONUKWUBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-871-2155
Mailing Address - Street 1:12211 FONDREN RD APT 702
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-4026
Mailing Address - Country:US
Mailing Address - Phone:832-871-2155
Mailing Address - Fax:832-871-2155
Practice Address - Street 1:12211 FONDREN RD APT 702
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-4026
Practice Address - Country:US
Practice Address - Phone:832-871-2155
Practice Address - Fax:832-871-2155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health