Healthcare Provider Details

I. General information

NPI: 1962616391
Provider Name (Legal Business Name): VICTOR OKEY ADIUKU ADMINISTRATOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 FONDREN RD SUITE 250C
HOUSTON TX
77096-4564
US

IV. Provider business mailing address

10101 FONDREN RD SUITE 250C
HOUSTON TX
77096-4564
US

V. Phone/Fax

Practice location:
  • Phone: 713-777-3434
  • Fax: 713-777-3593
Mailing address:
  • Phone: 713-777-3434
  • Fax: 713-777-3593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number010335
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number010335
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number010335
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number010335
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: