Provider Demographics
NPI:1740469840
Name:NCJ HEALTH SYSTEM INC
Entity type:Organization
Organization Name:NCJ HEALTH SYSTEM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:UDOKA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-772-4858
Mailing Address - Street 1:104 INDUSTRIAL BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3170
Mailing Address - Country:US
Mailing Address - Phone:713-772-4858
Mailing Address - Fax:713-772-4857
Practice Address - Street 1:104 INDUSTRIAL BLVD STE D
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3170
Practice Address - Country:US
Practice Address - Phone:713-772-4858
Practice Address - Fax:713-772-4857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010085251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679609Medicare Oscar/Certification