Healthcare Provider Details

I. General information

NPI: 1093375578
Provider Name (Legal Business Name): LLHC LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4281 BELT LINE RD
ADDISON TX
75001-4510
US

IV. Provider business mailing address

4281 BELT LINE RD
ADDISON TX
75001-4510
US

V. Phone/Fax

Practice location:
  • Phone: 214-377-9355
  • Fax:
Mailing address:
  • Phone: 214-377-9355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JASICA M GRAY
Title or Position: OWNER
Credential:
Phone: 214-377-9355