Healthcare Provider Details

I. General information

NPI: 1174358154
Provider Name (Legal Business Name): PDN HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2024
Last Update Date: 09/07/2024
Certification Date: 09/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18418 KILBOWIE PL
RICHMOND TX
77407-5048
US

IV. Provider business mailing address

18418 KILBOWIE PL
RICHMOND TX
77407-5048
US

V. Phone/Fax

Practice location:
  • Phone: 346-200-9501
  • Fax:
Mailing address:
  • Phone: 346-200-9501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: IFEANYI JIWUAKU
Title or Position: ADMINISTRATOR
Credential:
Phone: 713-576-6493