EXECUTIVE DE-TAILS (NPI# 1629134440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629134440 |
| Entity Type | Organization |
| Organization Name | EXECUTIVE DE-TAILS |
| Other Organization Name | EXECUTIVE DE-TAILS |
| Practice Address |
2952 Celian Dr Grand Prairie TX 75052-8737 |
| Practice Telephone | 8172475267 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MARK AIDELOJIE (CONSULTANT) |
| Authorized Official Telephone | 8172742284 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Executive De-Tails | Doing Business As Name - Organization |
| Street Address |
2952 CELIAN DR |
| City | GRAND PRAIRIE |
| State | TX |
| Zip Code | 75052-8737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710119052 | D&d Residential Services Inc | Nursing Care | 2952 Celian Dr, Grand Prairie, TX 75052-8737 | 2009-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487265542 | Beyond Home Health Care LLC | Registered Nurse | 3531 Pecos Way, Grand Prairie, TX 75052 | 2020-08-12 |
| 1497370332 | Michael Cooper | Dentist | 3154 South Hwy 161 Ste 640, Grand Prairie, TX 75052 | 2020-06-16 |
| 1043835788 | Amanda Azubike | Licensed Practical Nurse | 4593 Mt Laurel Dr, Grand Prairie, TX 75052 | 2020-06-09 |
| 1457992844 | Epic West Family Dnetistry Pllc | Dentist | 3166 Sh 161, Ste 190, Grand Prairie, TX 75052 | 2019-10-07 |
| 1033777487 | National Vision Inc | Optometrist | 3166 South Highway 161, Suite 160, Grand Prairie, TX 75052 | 2019-05-31 |
| 1689136624 | Raushanah Taherrah Shareef-jefferson | Dental Hygienist | 831 Ridgecrest Rd, Grand Prairie, TX 75052 | 2019-04-01 |
| 1053812552 | Dfw Better Care Physicians, Pllc | Clinic/Center | 5204 Tx 360 #400, Grand Prairie, TX 75052 | 2018-02-21 |
| 1629586797 | Grand Prairie Marvel Dental Pllc | Clinic/Center | 5020 S Hwy 360, Suite 200, Grand Prairie, TX 75052 | 2018-01-11 |
| 1033626221 | Thad Taylor Iv Dds | Dentist | 3261 S. Carrier Pkwy., Grand Prairie, TX 75052 | 2018-01-09 |
| 1902312796 | Real Dental Pllc | Dentist | 1215 W. Pioneer Pkwy, Suite 130, Grand Prairie, TX 75052 | 2017-12-16 |
| Find all providers in zip 75052 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104308931 | Reginah Mbula Ngwili | Contractor | 3318 Spring Meadow Ln, Grand Prairie, TX 75052-6482 | 2018-08-29 |
| 1396111019 | Tommy Lee Provost | Contractor | 5832 Midnight Ln, Grand Prairie, TX 75052-8585 | 2015-08-17 |
| 1073829883 | Marcie Frazier-martin | Contractor | 2768 Park Pl, Grand Prairie, TX 75052-8582 | 2010-08-31 |
| 1710126230 | Claude Russell Trotter IIi | Contractor | 674 W Warrior Trl, Grand Prairie, TX 75052-6099 | 2009-02-05 |
| 1861639718 | Jacqueline Lanae Fort | Contractor | 842 Pangburn St, Grand Prairie, TX 75051 | 2009-01-14 |
| 1134200389 | Sharon Ruth Jackson | Contractor | 2100 N. Hwy 360, Suite 1704, Grand Prairie, TX 75050-1062 | 2006-10-17 |
| 1801904644 | Dwight Lee | Contractor | 4223 Cedar Ridge Dr, Grand Prairie, TX 75052-2819 | 2006-08-29 |
| 1013933084 | Deborah A Burns | Contractor | 3122 S Holiday Dr, Grand Prairie, TX 75052-5857 | 2006-07-14 |
| 1598916991 | Moses B Fagbeyiro | Contractor | 2516 Wayne Way, Grand Prairie, TX 75052-7883 | 2008-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123228 | D and J Development | Contractor | 3016 N I 35 E, Lancaster, TX 75134-1851 | 2020-10-28 |
| 1427657659 | Mipcn, Inc. | Contractor | 9305 Hammerly Blvd, Houston, TX 77080-5413 | 2020-10-19 |
| 1497353569 | Mark Sanders | Contractor | 3046 Fordham Rd, Dallas, TX 75216-4819 | 2020-10-12 |
| 1215534227 | Michael Clark | Contractor | 1107 Lavender Shade Court, Houston, TX 77073 | 2020-10-02 |
| 1235744244 | Dignity Services LLC | Contractor | 1001 N Medford Rd, Brownsville, TX 78521-8474 | 2020-09-15 |
| 1568076826 | Hanaa Mohammed | Contractor | 6825 Huebner Rd # 680012, San Antonio, TX 78238-2108 | 2020-09-03 |
| 1609487107 | Lateshna D Oliver | Contractor | 1714 7th St, Wichita Falls, TX 76301-4223 | 2020-08-10 |
| 1588282354 | Tenzie May | Contractor | 5413 Mansel Ln, Fort Worth, TX 76134-1615 | 2020-07-08 |
| 1720605116 | Physmedics LLC | Contractor | 10900 Research Blvd., Ste 160-c, #3, Austin, TX 78759-5718 | 2020-07-01 |
| 1609493444 | Kizzey Ann Collins | Contractor | 810 Skyline Trl, Houston, TX 77019-2950 | 2020-06-27 |
| Find all providers with the same taxonomy | ||||
| City | GRAND PRAIRIE |
| Zip Code | 75052 |
Please comment or provide details below to improve the information on EXECUTIVE DE-TAILS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.