Healthcare Provider Details

I. General information

NPI: 1992962914
Provider Name (Legal Business Name): HEALTHY CHOICE HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 02/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 OLD SHEPARD PL SUITE 401
PLANO TX
75093-5279
US

IV. Provider business mailing address

4601 OLD SHEPARD PL SUITE 401
PLANO TX
75093-5279
US

V. Phone/Fax

Practice location:
  • Phone: 972-612-5370
  • Fax: 972-476-1138
Mailing address:
  • Phone: 972-612-5370
  • Fax: 972-476-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number012167
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MR. XINGKUI PAN
Title or Position: ADMINISTRATOR
Credential: OTR
Phone: 972-612-5370