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Organization
OMNI HOUSECALLS LLC
Active
Organization
OMNI HOUSECALLS LLC
Active
Other names
Medical Housecalls
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD STEPHENSON (PRESIDENT)
(469) 446-0524
Entity
Organization
Contact information
Practice address
2080 N STATE HIGHWAY 360, SUITE 370, GRAND PRAIRIE, TX 75050-1493
(972) 206-0347
(972) 206-0365
Mailing address
2080 N STATE HIGHWAY 360, SUITE 370, GRAND PRAIRIE, TX 75050-1493
(972) 206-0347
(972) 206-0365
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0043NN
BCBS
TX
05
—
179190701
—
TX
01
—
DE4339
RR MEDICARE
TX
Enumeration date
05/28/2006
Last updated
07/03/2008
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