Healthcare Provider Details

I. General information

NPI: 1023053139
Provider Name (Legal Business Name): MY MORNING STAR HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 04/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 NOLANA LOOP STE A
PHARR TX
78577
US

IV. Provider business mailing address

300 E NOLANA LOOP SUITE A
PHARR TX
78577-9684
US

V. Phone/Fax

Practice location:
  • Phone: 956-781-7827
  • Fax: 956-781-7830
Mailing address:
  • Phone: 956-781-7827
  • Fax: 956-781-7830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number010306
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. ESTELA TATOY SOTELO
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 956-781-7827