Healthcare Provider Details

I. General information

NPI: 1861153330
Provider Name (Legal Business Name): TEXAS TALENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 W GRAPEVINE MILLS CIR # 507
GRAPEVINE TX
76051-2096
US

IV. Provider business mailing address

2825 ROUNDUP TRL
GRAPEVINE TX
76051-4745
US

V. Phone/Fax

Practice location:
  • Phone: 682-477-3585
  • Fax: 682-477-3675
Mailing address:
  • Phone: 240-714-6679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: MOHAMMED GULAM RASUL KHAN
Title or Position: CEO
Credential:
Phone: 469-386-5586