Provider Demographics
NPI:1811766223
Name:LOVING HEARTS PEDIATRIC SERVICES, INC.
Entity type:Organization
Organization Name:LOVING HEARTS PEDIATRIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAMS
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-763-6191
Mailing Address - Street 1:7902 TROON DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-4800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7902 TROON DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-4800
Practice Address - Country:US
Practice Address - Phone:214-763-6191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health