=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689283145
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | IV & HOME HEALTH SERVICES OF TEXAS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/30/2020
-----------------------------------------------------
Last Update Date | 03/04/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7545 CHERRY PARK DR
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77095-2722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-217-3619
-----------------------------------------------------
Fax | 877-220-6086
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7545 CHERRY PARK DR
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77095-2722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-217-3619
-----------------------------------------------------
Fax | 877-220-6086
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ROB NEVILLE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-908-6353
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336H0001X
-----------------------------------------------------
Taxonomy Name | Home Infusion Therapy Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------