Healthcare Provider Details

I. General information

NPI: 1609862499
Provider Name (Legal Business Name): MEP & FAMILY HEALTHCARE AGENCY , INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 12/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 S MAIN ST
COPPERAS COVE TX
76522-2237
US

IV. Provider business mailing address

303 S MAIN ST
COPPERAS COVE TX
76522-2237
US

V. Phone/Fax

Practice location:
  • Phone: 254-542-2486
  • Fax: 254-547-8828
Mailing address:
  • Phone: 254-542-2486
  • Fax: 254-547-8828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. GOODLUCK O. PELEBO
Title or Position: PRESIDENT/OFFICE MANAGER
Credential:
Phone: 254-542-2486