1760702401 NPI number — GEMINI HOME HEALTH SERVICES INC.

Table of content: KENT REGER NIEDENS PHARM.D. (NPI 1689284630)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760702401 NPI number — GEMINI HOME HEALTH SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GEMINI HOME 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:
1760702401
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6015 PECOS VALLEY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77469-6141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-582-9150
Provider Business Mailing Address Fax Number:
281-498-9495

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6015 PECOS VALLEY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77469-6141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-582-9150
Provider Business Practice Location Address Fax Number:
281-498-9495
Provider Enumeration Date:
06/04/2010

Additional Information

Authorized Official

Authorized Official Last Name:
IYIOLA
Authorized Official First Name:
IBRAHEEM
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
713-478-3076

Provider Taxonomy Codes

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

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





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