Healthcare Provider Details

I. General information

NPI: 1386922615
Provider Name (Legal Business Name): AMAZING HOMECARE CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 AMANDA LEE
COMBINE TX
75159-5457
US

IV. Provider business mailing address

645 AMANDA LEE
COMBINE TX
75159-5457
US

V. Phone/Fax

Practice location:
  • Phone: 972-413-6165
  • Fax:
Mailing address:
  • Phone: 972-413-6165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ROY F. TUGGLE
Title or Position: VICE PRESIDENT
Credential:
Phone: 214-243-0471