Healthcare Provider Details

I. General information

NPI: 1003969130
Provider Name (Legal Business Name): BETHESDA HOME HEALTH CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8204 ELMBROOK DR SUITE 135
DALLAS TX
75247-4067
US

IV. Provider business mailing address

717 CARVER ST
MESQUITE TX
75149-5009
US

V. Phone/Fax

Practice location:
  • Phone: 214-879-0803
  • Fax: 214-879-0828
Mailing address:
  • Phone: 972-216-1818
  • Fax: 972-216-1919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number009188
License Number StateTX

VIII. Authorized Official

Name: GERALD DON HARMAN
Title or Position: GENERAL MANAGER
Credential:
Phone: 972-216-1818