Healthcare Provider Details

I. General information

NPI: 1487717237
Provider Name (Legal Business Name): EXPERT PRIMARY HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 BUSINESS PARK DR STE 10
MISSION TX
78572-6054
US

IV. Provider business mailing address

909 BUSINESS PARK DR STE 10
MISSION TX
78572-6054
US

V. Phone/Fax

Practice location:
  • Phone: 956-387-0500
  • Fax: 956-387-0501
Mailing address:
  • Phone: 956-387-0500
  • Fax: 956-387-0501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number017358
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: STACEY P ANAYA
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 956-387-0500