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General NPI Number Information
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NPI Number | 1780113563
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Entity Type | Organization
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Legal Business Name | FIDUS ACHATES, INC.
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 26607 RIDGESTONE PARK LN
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City | CYPRESS
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State | TX
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Zip | 77433-1282
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Country | US
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Telephone | 281-468-5912
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Fax |
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Provider Business Mailing Address
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Address Line | 26607 RIDGESTONE PARK LN
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City | CYPRESS
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State | TX
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Zip | 77433-1282
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Country | US
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Telephone | 281-468-5912
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Fax |
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Authorized Official
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Title or Position | CFO/ALTERNATE ADMINISTRATOR
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Name | KATHEEN SHARON BROWN
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Credential |
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Telephone | 832-529-4972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | TX
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