MK Healthcare Services LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

MK HEALTHCARE SERVICES LLC

Practice address

112 Garden Grove LN # Tx75154
Red Oak, TX 75154-0150

Phone

(817) 903-8467

Fax

(469) 552-6255

NPI assigned

Dec 13, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Manfred Bisong Enoh, REGISTERED NURSENPI 1184865933

Title

Administrator

Phone

(817) 903-8467

Specialties & licenses 1

Addresses

Other identifiers 5

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manfred Enoh

  • Case Manager/Care Coordinator
  • Arlington, TX
  • NPI 1184865933
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1447961248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 GARDEN GROVE LN # TX75154",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751540150",
            "telephone_number": "817-903-8467",
            "fax_number": "469-552-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 GARDEN GROVE LN # TX75154",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751540150",
            "telephone_number": "817-903-8467",
            "fax_number": "469-552-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MK HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "ENOH",
        "authorized_official_first_name": "MANFRED",
        "authorized_official_middle_name": "BISONG",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "817-903-8467",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "26386910",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOS",
            "identifier": "803707314",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "446173740",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "803707314",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOS",
            "identifier": "26386910",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nursing Care Agency in Red Oak, TX
• Providers in Red Oak, TX by specialty
• Nursing Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.