Healthcare Provider Details

I. General information

NPI: 1962808972
Provider Name (Legal Business Name): DEAR ANGELS HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 11/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 PERFORMANCE DR #128
RICHARDSON TX
75082-4536
US

IV. Provider business mailing address

2301 PERFORMANCE DR #128
RICHARDSON TX
75082-4536
US

V. Phone/Fax

Practice location:
  • Phone: 214-592-5174
  • Fax: 214-853-5891
Mailing address:
  • Phone: 214-592-5174
  • Fax: 214-853-5891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number015757
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number015757
License Number StateTX

VIII. Authorized Official

Name: MISS KATE OKWESA
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 214-592-5174