Healthcare Provider Details

I. General information

NPI: 1821395351
Provider Name (Legal Business Name): MEGASTAR HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2011
Last Update Date: 12/17/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3235 N MESQUITE DR STE 300
MESQUITE TX
75150-4044
US

IV. Provider business mailing address

3235 N MESQUITE DR STE 300
MESQUITE TX
75150-4044
US

V. Phone/Fax

Practice location:
  • Phone: 972-235-7100
  • Fax: 972-235-7101
Mailing address:
  • Phone: 972-235-7100
  • Fax: 972-235-7101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. SHAJU POTTAKKATTIL JOHN
Title or Position: ADMINISTRATOR
Credential:
Phone: 972-235-7100