Healthcare Provider Details

I. General information

NPI: 1336560549
Provider Name (Legal Business Name): SUMMY HOME HEALTH CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 12/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 GREENWOOD DR
SOUTHLAKE TX
76092-8360
US

IV. Provider business mailing address

594 GARDEN CT
SOUTHLAKE TX
76092-3500
US

V. Phone/Fax

Practice location:
  • Phone: 817-925-2979
  • Fax: 866-300-8627
Mailing address:
  • Phone: 817-925-2979
  • Fax: 866-300-8627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LLOYD SUMMY
Title or Position: PRESIDENT
Credential: MED BCBA
Phone: 817-925-2979