Healthcare Provider Details

I. General information

NPI: 1164964524
Provider Name (Legal Business Name): LEADS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2016
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16802 COOK LANDING DR
RICHMOND TX
77407-2617
US

IV. Provider business mailing address

16802 COOK LANDING DR
RICHMOND TX
77407-2617
US

V. Phone/Fax

Practice location:
  • Phone: 832-759-2435
  • Fax: 832-553-3054
Mailing address:
  • Phone: 832-759-2435
  • Fax: 832-553-3054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateTX

VIII. Authorized Official

Name: MR. EYITAYO ADEDOLAPO LAOGUN
Title or Position: BUSINESS MANAGER
Credential: MSA
Phone: 832-382-8867