Healthcare Provider Details

I. General information

NPI: 1134369788
Provider Name (Legal Business Name): MEDHEALTH HOUSECALLS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 02/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 CHESAPEAKE DR
GARLAND TX
75043-0901
US

IV. Provider business mailing address

2605 CHESAPEAKE DR
GARLAND TX
75043-0901
US

V. Phone/Fax

Practice location:
  • Phone: 214-714-0117
  • Fax:
Mailing address:
  • Phone: 214-714-0117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TIMONET BLANDO ABULOC
Title or Position: PRESIDENT
Credential: RN,MSN,FNP
Phone: 214-714-0117