Provider Demographics
NPI:1053459693
Name:CEZANNE CORPORATION
Entity type:Organization
Organization Name:CEZANNE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:MILES
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-504-9768
Mailing Address - Street 1:1105 SHADY OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5213
Mailing Address - Country:US
Mailing Address - Phone:214-504-9768
Mailing Address - Fax:214-342-0151
Practice Address - Street 1:1105 SHADY OAKS CIR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5213
Practice Address - Country:US
Practice Address - Phone:214-504-9768
Practice Address - Fax:214-342-0151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health