Healthcare Provider Details

I. General information

NPI: 1174092092
Provider Name (Legal Business Name): ATLAS VISITING PROVIDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2018
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GLENBOROUGH DR STE 550
HOUSTON TX
77067-3600
US

IV. Provider business mailing address

100 GLENBOROUGH DR STE 550
HOUSTON TX
77067-3600
US

V. Phone/Fax

Practice location:
  • Phone: 469-916-1906
  • Fax: 469-916-3641
Mailing address:
  • Phone: 469-916-1906
  • Fax: 469-916-3641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. KAMALDEEN ISIAKA
Title or Position: OWNING MEMBER
Credential: FNP-BC
Phone: 469-916-1906