Healthcare Provider Details

I. General information

NPI: 1891974804
Provider Name (Legal Business Name): FAGLO HOME HEALTH AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 WOODED GLEN DR
SUNNYVALE TX
75182-2653
US

IV. Provider business mailing address

291 WOODED GLEN DR
SUNNYVALE TX
75182-2653
US

V. Phone/Fax

Practice location:
  • Phone: 469-231-3711
  • Fax:
Mailing address:
  • Phone: 469-231-3711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number011486
License Number StateTX

VIII. Authorized Official

Name: GLORIA UCHEBUNMA NWEKE
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 469-231-3711