Healthcare Provider Details

I. General information

NPI: 1710921937
Provider Name (Legal Business Name): EMMANUEL A. OFILI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9119 S GESSNER DR STE 113
HOUSTON TX
77074-2874
US

IV. Provider business mailing address

9119 S GESSNER DR
HOUSTON TX
77074-2845
US

V. Phone/Fax

Practice location:
  • Phone: 713-271-8224
  • Fax: 713-271-3078
Mailing address:
  • Phone: 713-271-8224
  • Fax: 713-271-3078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number001007698
License Number StateTX

VIII. Authorized Official

Name: MR. EMMANUEL A OFILI
Title or Position: PROGRAM PROVIDER/CEO
Credential: PROVIDER
Phone: 713-271-8224