=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821086026
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STAR HEALTH CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/11/2005
-----------------------------------------------------
Last Update Date | 08/02/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10518 KIPP WAY DR SUITE B-1
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77099-2400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-288-4928
-----------------------------------------------------
Fax | 832-288-4844
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10518 KIPP WAY DR SUITE B-1
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77099-2400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-288-4928
-----------------------------------------------------
Fax | 832-288-4844
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MR. RAMON BANAYAD BANEA
-----------------------------------------------------
Credential | R.N.
-----------------------------------------------------
Telephone | 832-288-4928
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 008182
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------