Healthcare Provider Details

I. General information

NPI: 1053809459
Provider Name (Legal Business Name): ST PETER HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2018
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6811 WINSTON DR
FRISCO TX
75035-8630
US

IV. Provider business mailing address

6811 WINSTON DR
FRISCO TX
75035-8630
US

V. Phone/Fax

Practice location:
  • Phone: 469-203-3878
  • Fax: 877-710-7898
Mailing address:
  • Phone: 469-203-3878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANZOA ROSOUR
Title or Position: ADMINISTRATOR
Credential:
Phone: 469-203-3878