Healthcare Provider Details

I. General information

NPI: 1649676859
Provider Name (Legal Business Name): THUNDER HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2014
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13805 GREEN HOOK RD
ALEDO TX
76008-1700
US

IV. Provider business mailing address

13805 GREEN HOOK RD
ALEDO TX
76008-1700
US

V. Phone/Fax

Practice location:
  • Phone: 469-735-0194
  • Fax: 682-200-2635
Mailing address:
  • Phone: 469-735-0194
  • Fax: 682-200-2635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: NEVILLE TSHIAMALA
Title or Position: ADMINISTRATOR
Credential:
Phone: 469-735-0194