=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548213523
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NIRON HEALTH CARE SERVICES INCORPORATED
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2006
-----------------------------------------------------
Last Update Date | 11/01/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11104 W AIRPORT BLVD STE 110
-----------------------------------------------------
City | STAFFORD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77477-3016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-776-0030
-----------------------------------------------------
Fax | 281-776-0032
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11104 W AIRPORT BLVD STE 110
-----------------------------------------------------
City | STAFFORD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77477-3016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-776-0030
-----------------------------------------------------
Fax | 281-776-0032
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ALTERNATE ADMINISTRATOR
-----------------------------------------------------
Name | MR. NELSON KALU IRO
-----------------------------------------------------
Credential | MSC
-----------------------------------------------------
Telephone | 281-776-0030
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 010360
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------