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General NPI Number Information
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NPI Number | 1689302861
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Entity Type | Organization
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Legal Business Name | ACTFAST HEALTHCARE LLC
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 2000 E ARAPAHO RD APT 22303
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City | RICHARDSON
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State | TX
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Zip | 75081-7709
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Country | US
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Telephone | 945-249-0615
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 E ARAPAHO RD APT 22303
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City | RICHARDSON
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State | TX
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Zip | 75081-7709
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Country | US
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Telephone | 972-891-1700
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | BLESSING OKON OKPO
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Credential | NP
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Telephone | 972-891-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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