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General NPI Number Information
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NPI Number | 1972459246
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Entity Type | Organization
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Legal Business Name | DE-MONDEK HOME CARE PROVIDER SERVICES LLC
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 10333 HARWIN DR STE 263
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City | HOUSTON
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State | TX
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Zip | 77036-1773
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Country | US
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Telephone | 713-527-8021
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Fax |
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Provider Business Mailing Address
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Address Line | 8711 OLIVE BRANCH CT
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City | HOUSTON
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State | TX
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Zip | 77083-5786
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Country | US
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Telephone | 713-517-8021
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | OBIANUJU DERAH OBIEZE
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Credential |
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Telephone | 713-517-8021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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