Organization
IOCCK HEALTHCARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IFEANYI DURUEWURU FNP (OWNER/MANAGER)
(214) 906-5427
Entity
Organization
Contact information
Practice address
2875 GRANDVIEW DR, GRAND PRAIRIE, TX 75052-8518
(214) 906-5427
Mailing address
2875 GRANDVIEW DR, GRAND PRAIRIE, TX 75052-8518
(214) 906-5427
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
314000000X
Skilled Nursing Facility
—
—
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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