Provider Demographics
NPI:1871705426
Name:TYNET HEALTHCARE INC
Entity type:Organization
Organization Name:TYNET HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PORTIA
Authorized Official - Middle Name:NGOZI
Authorized Official - Last Name:MBAH
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:817-385-8888
Mailing Address - Street 1:4108 MULBERRY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-1058
Mailing Address - Country:US
Mailing Address - Phone:817-385-8888
Mailing Address - Fax:877-504-7060
Practice Address - Street 1:4108 MULBERRY DR STE 100
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-1058
Practice Address - Country:US
Practice Address - Phone:817-385-8888
Practice Address - Fax:877-504-7060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX342867401Medicaid
TX021827OtherHCSSA