Provider Demographics
NPI:1427273473
Name:LUCKY HEALTHCARE SVC INC
Entity type:Organization
Organization Name:LUCKY HEALTHCARE SVC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:NKECHI
Authorized Official - Last Name:OSUAGWY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-773-1066
Mailing Address - Street 1:10103 FONDREN
Mailing Address - Street 2:SUITE 460
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096
Mailing Address - Country:US
Mailing Address - Phone:713-773-1066
Mailing Address - Fax:713-773-0445
Practice Address - Street 1:10103 FONDREN
Practice Address - Street 2:SUITE 460
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096
Practice Address - Country:US
Practice Address - Phone:713-773-1066
Practice Address - Fax:713-773-0445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10021538OtherAMERIGROUP