MEDICARE: PREMIUM CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1265366488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIUM CARE LLC

Provider Business Mailing Address
First Line	:	3025 NORI SHORES DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-6703
Country	:	US
Telephone Number	:	346-537-9250
Fax Number	:

Provider Business Practice Location Address
First Line	:	3025 NORI SHORES DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-6703
Country	:	US
Telephone Number	:	346-537-9250
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAMIKA GRAHAM
Credential	:
Telephone Number	:	346-537-9250

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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Directions to “PREMIUM CARE LLC ” Practice Location

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