MEDICARE: PATIENT RECOVERY HEALTHCARE MANAGEMENT SERVICES, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	3747P1801X	Personal Care Attendant
2	251E00000X	Home Health Agency	TX
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1861701260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATIENT RECOVERY HEALTHCARE MANAGEMENT SERVICES, LLC

Provider Business Mailing Address
First Line	:	505 N. SAM HOUSTON PKWY E.
Second Line	:	SUITE 680
City	:	HOUSTON
State	:	TX
Zip	:	77060-4094
Country	:	US
Telephone Number	:	281-447-1010
Fax Number	:	281-447-1313

Provider Business Practice Location Address
First Line	:	505 N. SAM HOUSTON PKWY E.
Second Line	:	SUITE 680
City	:	HOUSTON
State	:	TX
Zip	:	77060-4094
Country	:	US
Telephone Number	:	281-447-1010
Fax Number	:	281-447-1313

Authorized Official
Title or Position	:	EXECUTIVE ADMINISTRATOR
Name	:	DYRREN D DAVIS
Credential	:	PH.D.
Telephone Number	:	281-447-1010

Provider Enumeration Date	:	10/02/2010
Last Update Date	:	05/23/2023

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