MEDICARE: ADVANCED PRACTICE HOUSE CALLS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363LA2100X	Acute Care Nurse Practitioner
2	363LA2200X	Adult Health Nurse Practitioner
3	363LC0200X	Critical Care Medicine Nurse Practitioner
4	363LF0000X	Family Nurse Practitioner
5	363LG0600X	Gerontology Nurse Practitioner
6	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1841830445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PRACTICE HOUSE CALLS LLC

Provider Business Mailing Address
First Line	:	2646 S LOOP W STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2665
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2646 S LOOP W STE 330
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2773
Country	:	US
Telephone Number	:	832-889-9390
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	AHMAD AMIRDASH
Credential	:	AGACNP,MS, BBA, CCRN
Telephone Number	:	832-889-9390

Provider Enumeration Date	:	01/10/2020
Last Update Date	:	11/18/2024

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