MEDICARE: PRESTIGE HOME HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	344600000X	Taxi

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053990143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESTIGE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	7846 OAKINGTON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2119
Country	:	US
Telephone Number	:	832-242-3710
Fax Number	:	281-310-6734

Provider Business Practice Location Address
First Line	:	7846 OAKINGTON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2119
Country	:	US
Telephone Number	:	832-242-3710
Fax Number	:	281-310-6734

Authorized Official
Title or Position	:	ADMIN
Name	:	KATRINA SHANTAL DAVIS
Credential	:
Telephone Number	:	832-242-3710

Provider Enumeration Date	:	04/06/2021
Last Update Date	:	05/07/2021

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Directions to “PRESTIGE HOME HEALTH LLC ” Practice Location

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