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General NPI Number Information
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NPI Number | 1093945701
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Entity Type | Organization
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Legal Business Name | BETHEL AMERICA HEALTH CARE LLC
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11104 W AIRPORT BLVD STE 107
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City | STAFFORD
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State | TX
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Zip | 77477-3016
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Country | US
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Telephone | 832-770-9125
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Fax | 832-770-9253
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Provider Business Mailing Address
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Address Line | 11104 W AIRPORT BLVD STE 107
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City | STAFFORD
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State | TX
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Zip | 77477-3016
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Country | US
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Telephone | 832-770-9125
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Fax | 832-770-9253
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. YAMILET FERNANDEZ
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Credential |
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Telephone | 832-770-9125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 68783
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License Number State |
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