Provider Demographics
NPI:1417250556
Name:MORNING STAR HEALTHCARE SERVICES PA
Entity type:Organization
Organization Name:MORNING STAR HEALTHCARE SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLAWOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-829-0098
Mailing Address - Street 1:13615 NEUTRON RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-4411
Mailing Address - Country:US
Mailing Address - Phone:972-829-0098
Mailing Address - Fax:972-436-0145
Practice Address - Street 1:13615 NEUTRON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-4411
Practice Address - Country:US
Practice Address - Phone:972-829-0098
Practice Address - Fax:972-436-0145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-12
Last Update Date:2010-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5497261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care