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General NPI Number Information
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NPI Number | 1992963318
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Entity Type | Organization
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Legal Business Name | PALOMA HOME HEALTH AGENCY INC.
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 13601 PRESTON RD SUITE 225E
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City | DALLAS
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State | TX
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Zip | 75240-4911
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Country | US
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Telephone | 972-346-2013
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Fax | 972-853-7085
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Provider Business Mailing Address
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Address Line | PO BOX 700694
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City | DALLAS
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State | TX
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Zip | 75370-0694
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Country | US
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Telephone | 972-346-2013
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Fax | 972-853-7085
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. NICODEMUS ODHIAMBO OBUYA
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Credential | RN
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Telephone | 972-346-2013
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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 | 012184
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License Number State | TX
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