Provider Demographics
NPI:1174603187
Name:DANGLEN, INCORPORATED
Entity type:Organization
Organization Name:DANGLEN, INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WALDREP
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:281-957-9516
Mailing Address - Street 1:5870 HIGHWAY 6 N STE 214
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1802
Mailing Address - Country:US
Mailing Address - Phone:281-957-9516
Mailing Address - Fax:281-309-0109
Practice Address - Street 1:5870 HIGHWAY 6 N STE 214
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-1802
Practice Address - Country:US
Practice Address - Phone:281-957-9516
Practice Address - Fax:281-309-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67-9008251E00000X
TX007403251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679008Medicare Oscar/Certification