Provider Demographics
NPI:1306053103
Name:FAVORITE HEALTH COOPERATION
Entity type:Organization
Organization Name:FAVORITE HEALTH COOPERATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:OSITA
Authorized Official - Last Name:OKOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-731-0034
Mailing Address - Street 1:7290 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5309
Mailing Address - Country:US
Mailing Address - Phone:972-731-0034
Mailing Address - Fax:
Practice Address - Street 1:7290 HICKORY ST
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5309
Practice Address - Country:US
Practice Address - Phone:972-731-0034
Practice Address - Fax:972-731-0041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0081434332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1770497Medicaid
SC5559480001Medicare ID - Type Unspecified