Healthcare Provider Details

I. General information

NPI: 1770315749
Provider Name (Legal Business Name): MERIWOOD LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2024
Last Update Date: 08/17/2024
Certification Date: 08/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SUGAR GROVE BLVD STE 250
STAFFORD TX
77477-2639
US

IV. Provider business mailing address

9801 WESTHEIMER RD STE 300
HOUSTON TX
77042-3979
US

V. Phone/Fax

Practice location:
  • Phone: 832-554-6773
  • Fax:
Mailing address:
  • Phone: 832-554-6773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: IYABO OMIDIWURA
Title or Position: ADMINISTRATOR
Credential: CNP
Phone: 832-554-6773