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General NPI Number Information
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NPI Number | 1215188859
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Entity Type | Organization
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Legal Business Name | G12 HEALTHPOINT SERVICES, INC
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Dates
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Enumeration Date | 10/01/2008
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Last Update Date | 10/01/2008
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Provider Practice Location Address
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Address Line | 1165 CALVERT DR
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City | CEDAR HILL
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State | TX
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Zip | 75104-2303
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Country | US
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Telephone | 214-524-9915
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Fax |
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Provider Business Mailing Address
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Address Line | 1165 CALVERT DR
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City | CEDAR HILL
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State | TX
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Zip | 75104-2303
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Country | US
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Telephone | 214-524-9915
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIMOTHY NWOKORIE
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Credential | LVN
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Telephone | 214-524-9915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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