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General NPI Number Information
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NPI Number | 1134931835
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Entity Type | Organization
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Legal Business Name | BRONZE STAR HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 14457 MEADOW GLEN RD
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City | LINDALE
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State | TX
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Zip | 75771-0137
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Country | US
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Telephone | 430-235-1086
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Fax | 430-235-1087
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Provider Business Mailing Address
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Address Line | 14457 MEADOW GLEN RD
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City | LINDALE
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State | TX
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Zip | 75771-0137
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Country | US
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Telephone | 430-235-1086
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Fax | 430-235-1087
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Authorized Official
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Title or Position | OWNER
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Name | KEVIN W DAVIS
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Credential |
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Telephone | 430-235-1086
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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 |
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License Number State |
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