Healthcare Provider Details

I. General information

NPI: 1164095584
Provider Name (Legal Business Name): HECEN HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 ROBINSON RD STE 220
CORINTH TX
76210-2848
US

IV. Provider business mailing address

1420 ROBINSON RD STE 220
CORINTH TX
76210-2848
US

V. Phone/Fax

Practice location:
  • Phone: 214-727-8833
  • Fax:
Mailing address:
  • Phone: 214-727-8833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ESTHER UGO UANGBAOJE
Title or Position: APRN PMHNP-BC
Credential:
Phone: 214-727-8833