Healthcare Provider Details

I. General information

NPI: 1104501279
Provider Name (Legal Business Name): EMPOWER HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2023
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 W MONTGOMERY ST UNIT H
WILLIS TX
77378-8649
US

IV. Provider business mailing address

309 W MONTGOMERY ST UNIT H
WILLIS TX
77378-8649
US

V. Phone/Fax

Practice location:
  • Phone: 936-280-4782
  • Fax: 936-233-8889
Mailing address:
  • Phone: 936-280-4782
  • Fax: 936-233-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: AMANDA MUDGE
Title or Position: SUPERVISING NURSE
Credential:
Phone: 832-604-3416