Healthcare Provider Details

I. General information

NPI: 1578862660
Provider Name (Legal Business Name): ST. ROYAL HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2011
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2656 S LOOP W
HOUSTON TX
77054-2664
US

IV. Provider business mailing address

2656 S LOOP W STE 329
HOUSTON TX
77054-2664
US

V. Phone/Fax

Practice location:
  • Phone: 713-817-2959
  • Fax: 713-664-9801
Mailing address:
  • Phone: 713-817-2959
  • Fax: 713-664-9801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number014155
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number014155
License Number StateTX

VIII. Authorized Official

Name: MS. LUCINDA LYONS ANTOINE
Title or Position: PRESIDENT
Credential: RN
Phone: 713-817-6613