Healthcare Provider Details

I. General information

NPI: 1780073460
Provider Name (Legal Business Name): 1ST CHOICE TEXAS HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2015
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 E RENFRO ST SUITE 107
BURLESON TX
76028-4279
US

IV. Provider business mailing address

4720 RUSH RIVER TRL
FORT WORTH TX
76123-2751
US

V. Phone/Fax

Practice location:
  • Phone: 817-471-3117
  • Fax: 888-443-4937
Mailing address:
  • Phone: 682-234-8147
  • Fax: 888-443-4937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: MALYNETTE DINO
Title or Position: ADMINISTRATOR
Credential: RN, BSN
Phone: 682-234-8147