Healthcare Provider Details

I. General information

NPI: 1538026828
Provider Name (Legal Business Name): FANA REALTY ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30707 LILY TRACE CT
SPRING TX
77386-3899
US

IV. Provider business mailing address

30707 LILY TRACE CT
SPRING TX
77386-3899
US

V. Phone/Fax

Practice location:
  • Phone: 832-299-8056
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. FALLON NGECHA
Title or Position: FOUNDER & CEO
Credential:
Phone: 832-299-8056