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General NPI Number Information
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NPI Number | 1235458662
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Entity Type | Organization
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Legal Business Name | HIS STRIPES HEALTHCARE SERVICES PLLC
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Dates
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Enumeration Date | 05/25/2010
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 500 N CENTRAL EXPY STE 500
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City | PLANO
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State | TX
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Zip | 75074-6703
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Country | US
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Telephone | 972-261-8327
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N CENTRAL EXPY STE 500
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City | PLANO
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State | TX
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Zip | 75074-6703
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Country | US
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Telephone | 972-261-8327
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Fax |
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Authorized Official
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Title or Position | ADMIN/ OWNER
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Name | VICTORIA NGOZI IWUOHA
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Credential |
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Telephone | 972-261-8367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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