CDS Account Managers, LLC

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

Legal business name

CDS ACCOUNT MANAGERS, LLC

Practice address

1206 Bayside Dr
Wylie, TX 75098-7806

Phone

(214) 724-1499

NPI assigned

May 4, 2015

Last updated

Jul 2, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Fortune Ezeoha

Title

Administrator

Phone

(214) 724-1499

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593648000000",
    "number": "1558748152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 BAYSIDE DR",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750987806",
            "telephone_number": "214-724-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 BAYSIDE DR",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750987806",
            "telephone_number": "214-724-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDS ACCOUNT MANAGERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "EZEOHA",
        "authorized_official_first_name": "FORTUNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-724-1499",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001025963",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001025964",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001025962",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Supports Brokerage Agency in Wylie, TX
• Providers in Wylie, TX by specialty
• Supports Brokerage Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.