Healthcare Provider Details

I. General information

NPI: 1295779023
Provider Name (Legal Business Name): CUDDLE ME HOME CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 06/25/2020
Certification Date: 06/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10935 ESTATE LANE SUITE 190
DALLAS TX
75238
US

IV. Provider business mailing address

10935 ESTATE LANE SUITE 190
DALLAS TX
75238
US

V. Phone/Fax

Practice location:
  • Phone: 972-226-1015
  • Fax: 972-226-1814
Mailing address:
  • Phone: 972-226-1015
  • Fax: 972-226-1814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number013708
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number013708
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number009288
License Number StateTX
# 6
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number013708
License Number StateTX

VIII. Authorized Official

Name: CORINE DJEUKOUA NGAHA
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 214-272-9206