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General NPI Number Information
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NPI Number | 1114225364
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Entity Type | Organization
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Legal Business Name | EDWARDS-TRINITY HEALTHCARE, INC.
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 9696 SKILLMAN ST STE. 225
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City | DALLAS
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State | TX
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Zip | 75243-8264
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Country | US
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Telephone | 214-622-2513
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Fax | 214-553-5138
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Provider Business Mailing Address
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Address Line | 9696 SKILLMAN ST STE. 225
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City | DALLAS
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State | TX
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Zip | 75243-8264
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Country | US
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Telephone | 214-622-2513
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Fax | 214-553-5138
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. PAULLY N OKEA SR.
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Credential |
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Telephone | 214-622-2513
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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 | 011348
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License Number State | TX
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