Healthcare Provider Details

I. General information

NPI: 1871008763
Provider Name (Legal Business Name): KANOPY SOFTWARE LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2017
Last Update Date: 12/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21734 PROVINCIAL BLVD STE 240I
KATY TX
77450-6534
US

IV. Provider business mailing address

21734 PROVINCIAL BLVD STE 240
KATY TX
77450-6534
US

V. Phone/Fax

Practice location:
  • Phone: 832-808-9387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name: DUSTIN NEAL WARD
Title or Position: MANAGING MEMBER
Credential:
Phone: 832-808-9387