Havilah Mobile Wound Healing Services LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

HAVILAH MOBILE WOUND HEALING SERVICES LLC

Practice address

7308 Forest Bend Dr
Parker, TX 75002-6817

Phone

(972) 922-4510

Fax

(972) 442-0113

NPI assigned

Feb 17, 2025

Last updated

Feb 17, 2025By 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

Eziaku Jennifer OliverNPI 1205641073

Title

Administrator

Phone

(972) 922-4510

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eziaku Jennifer Oliver, DR.

  • Family Nurse Practitioner
  • Parker, TX
  • NPI 1205641073
  Medicare reassignment Care Compare group NPD Authorized official
• Doris Udosen, NP

  • Acute Care Nurse Practitioner
  • Tyler, TX
  • NPI 1700369808
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1730984428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7308 FOREST BEND DR",
            "city": "PARKER",
            "state": "TX",
            "postal_code": "750026817",
            "telephone_number": "972-922-4510",
            "fax_number": "972-442-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7308 FOREST BEND DR",
            "city": "PARKER",
            "state": "TX",
            "postal_code": "750026817",
            "telephone_number": "972-922-4510",
            "fax_number": "972-442-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVILAH MOBILE WOUND HEALING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "EZIAKU",
        "authorized_official_middle_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-922-4510"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Dheer, DPT
• Kathryn D Fix, RDH
• Alexis Garay, BCBA, LBA
• Chelsea Gilmore, M.S., LPC
• Shiza Haroon, DMD
• Carolyn Hollins
• Shirley Honrales, PHYSICAL THERAPIST
• Saad Syed Hussain, M.D
• Just Move It Chiropractic LLC
• Kharis Dental, PC

• Family Nurse Practitioner in Parker, TX
• Providers in Parker, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.