Healthcare Provider Details

I. General information

NPI: 1689021883
Provider Name (Legal Business Name): PBHS HOME HEALTH DFW I, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6974 WAVERLY LN
FRISCO TX
75035-7791
US

IV. Provider business mailing address

6974 WAVERLY LN
FRISCO TX
75035-7791
US

V. Phone/Fax

Practice location:
  • Phone: 469-256-6661
  • Fax: 866-636-4067
Mailing address:
  • Phone: 469-256-6661
  • Fax: 866-636-4067

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: TIM BARTHOLOMEW
Title or Position: ADMINISTRATOR
Credential:
Phone: 469-256-6661