Healthcare Provider Details

I. General information

NPI: 1013558329
Provider Name (Legal Business Name): TX PRESTIGE HOME HEALTH, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2019
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 E TRINITY MILLS RD STE 340
CARROLLTON TX
75006-1942
US

IV. Provider business mailing address

1301 CARLET DR
LITTLE ELM TX
75068-1656
US

V. Phone/Fax

Practice location:
  • Phone: 214-499-8139
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PEARL EBOSON
Title or Position: PRESIDENT
Credential:
Phone: 281-705-8179