=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811200413
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HICE HEALTHCARE SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2010
-----------------------------------------------------
Last Update Date | 11/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12300 FORD RD SUITE # 413
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75234-7248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-826-6647
-----------------------------------------------------
Fax | 972-243-1400
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7540 SILVERBROOK LN
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034-4471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-826-6647
-----------------------------------------------------
Fax | 972-243-1400
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINSTRATOR
-----------------------------------------------------
Name | MISS CATHERINE OWIYE ODIM
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 409-356-9778
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------