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General NPI Number Information
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NPI Number | 1922251487
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Entity Type | Organization
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Legal Business Name | DEVOTED HEALTHCARE AT HOME, LLC
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 2809 SAN FELIPE DR
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City | DENTON
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State | TX
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Zip | 76210-0351
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Country | US
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Telephone | 940-381-6908
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Fax | 940-381-6908
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Provider Business Mailing Address
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Address Line | 2809 SAN FELIPE DR
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City | DENTON
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State | TX
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Zip | 76210-0351
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Country | US
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Telephone | 940-381-6908
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Fax | 940-381-6908
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Authorized Official
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Title or Position | OWNER
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Name | MS. JILL ARNOLD WATSON
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Credential | FNP-C
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Telephone | 214-662-9893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 630478
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License Number State | TX
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