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General NPI Number Information
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NPI Number | 1538248877
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Entity Type | Organization
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Legal Business Name | HOME CARE ETC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 10/13/2009
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Provider Practice Location Address
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Address Line | 2110 HILLSIDE DR SUITE 200
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City | ROWLETT
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State | TX
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Zip | 75088-1514
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Country | US
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Telephone | 972-974-6141
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Fax | 469-366-3520
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Provider Business Mailing Address
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Address Line | PO BOX 2150
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City | ROWLETT
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State | TX
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Zip | 75030-2150
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Country | US
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Telephone | 214-415-7369
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Fax | 469-366-3520
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PATRICK OMORAGBON
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Credential |
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Telephone | 972-974-6141
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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 | 010877
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License Number State | TX
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