Healthcare Provider Details

I. General information

NPI: 1538494398
Provider Name (Legal Business Name): BMO HEALTHCARE GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2009
Last Update Date: 02/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13122 BROOKSIDE DR
SUGAR LAND TX
77478-2787
US

IV. Provider business mailing address

13122 BROOKSIDE DR
SUGAR LAND TX
77478-2787
US

V. Phone/Fax

Practice location:
  • Phone: 281-636-3165
  • Fax: 281-857-6746
Mailing address:
  • Phone: 281-636-3165
  • Fax: 281-857-6746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NKOLI EZENWA
Title or Position: PRESIDENT
Credential:
Phone: 281-564-5556