Healthcare Provider Details

I. General information

NPI: 1619204468
Provider Name (Legal Business Name): ENNIS TEXAS PHYSICIAN'S CHOICE HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E MAIN ST
MESQUITE TX
75149-4318
US

IV. Provider business mailing address

200 E MAIN ST
MESQUITE TX
75149-4318
US

V. Phone/Fax

Practice location:
  • Phone: 972-686-7602
  • Fax: 972-686-7475
Mailing address:
  • Phone: 972-686-7602
  • Fax: 972-686-7475

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MRS. DELAUNTE MISHELL CRAWFORD
Title or Position: ADMINISTRATOR
Credential: RN BSN
Phone: 972-686-7602