1912143777 NPI number — TENDER CARE HEALTHCARE SERVICES

Table of content: DR. VISHWANATH MUKKAMALLA REDDY MD (NPI 1952375354)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912143777 NPI number — TENDER CARE HEALTHCARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TENDER CARE HEALTHCARE SERVICES
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:
1912143777
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/31/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2929 HAYES RD APT 1308
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77082-2685
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-373-5026
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2929 HAYES RD APT 1308
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77082-2685
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-373-5026
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/29/2008

Additional Information

Authorized Official

Authorized Official Last Name:
AJIBADE
Authorized Official First Name:
MICHEAL
Authorized Official Middle Name:
ADETIDOYE
Authorized Official Title or Position:
CO-OWNER
Authorized Official Telephone Number:
832-373-5026

Provider Taxonomy Codes

  • Taxonomy code: 253J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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