Provider Demographics
NPI:1457608176
Name:DUNAMIS HEALTH SERVICES
Entity type:Organization
Organization Name:DUNAMIS HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHINA
Authorized Official - Middle Name:O
Authorized Official - Last Name:WEARY
Authorized Official - Suffix:
Authorized Official - Credentials:06/25/1964
Authorized Official - Phone:713-541-0536
Mailing Address - Street 1:10103 FONDREN RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4556
Mailing Address - Country:US
Mailing Address - Phone:832-390-6222
Mailing Address - Fax:713-988-9700
Practice Address - Street 1:10103 FONDREN RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4556
Practice Address - Country:US
Practice Address - Phone:832-390-6222
Practice Address - Fax:713-988-9700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUNAMIS HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherEIN #