MEDICARE: VIVID CARE SERVICES 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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1639041338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIVID CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1601 INDUSTRIAL BLVD STE 3049
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-2602
Country	:	US
Telephone Number	:	346-762-3056
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 INDUSTRIAL BLVD STE 3049
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-2602
Country	:	US
Telephone Number	:	346-762-3056
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NANCY ANYANWU
Credential	:
Telephone Number	:	832-860-0261

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	10/02/2025

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