Provider Demographics
NPI:1285964106
Name:HEFTY HEALTHCARE SERVICES INC.
Entity type:Organization
Organization Name:HEFTY HEALTHCARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADON
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:UCHE
Authorized Official - Last Name:NWANKWO
Authorized Official - Suffix:SR
Authorized Official - Credentials:RN
Authorized Official - Phone:832-892-4405
Mailing Address - Street 1:9100 SOUTHWEST FWY STE 225
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1583
Mailing Address - Country:US
Mailing Address - Phone:281-815-5192
Mailing Address - Fax:832-834-5148
Practice Address - Street 1:9100 SOUTHWEST FWY STE 225
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1583
Practice Address - Country:US
Practice Address - Phone:281-815-5192
Practice Address - Fax:832-834-5148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-29
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747810Medicare UPIN
TX747810Medicare Oscar/Certification