1548491244 NPI number — AMERICAN FAMILY HEALTH SERVICES INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548491244 NPI number — AMERICAN FAMILY HEALTH SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN FAMILY HEALTH SERVICES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548491244
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7227 PARKWOOD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SACHSE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75048-1907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-429-3902
Provider Business Mailing Address Fax Number:
972-429-3903

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
204 INDUSTRIAL CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WYLIE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75098-3952
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-429-3902
Provider Business Practice Location Address Fax Number:
972-429-3903
Provider Enumeration Date:
07/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MUSA
Authorized Official First Name:
DIRISU
Authorized Official Middle Name:
AFOLABI
Authorized Official Title or Position:
DIRECTOR OF NURSING/ADMINISTRATOR
Authorized Official Telephone Number:
972-429-3902

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2880171 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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