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General NPI Number Information
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NPI Number | 1962507939
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Entity Type | Organization
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Legal Business Name | HOME HEALTH AGENCY-HOUSTON, INC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 12555A GULF FWY SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77034-4509
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Country | US
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Telephone | 281-481-2568
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Fax | 281-481-2968
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Provider Business Mailing Address
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Address Line | 12555A GULF FWY SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77034-4509
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Country | US
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Telephone | 281-481-2568
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Fax | 281-481-2968
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | MR. WALTER TRACY CLARK
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Credential |
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Telephone | 954-753-4883
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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 | 011208
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License Number State | TX
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