MEDICARE: DALYAN CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1164978631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALYAN CARE LLC

Provider Business Mailing Address
First Line	:	14405 WALTERS RD STE 810
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1571
Country	:	US
Telephone Number	:	281-919-1876
Fax Number	:

Provider Business Practice Location Address
First Line	:	14405 WALTERS RD STE 810
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1571
Country	:	US
Telephone Number	:	281-919-1876
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MEMBER
Name	:	MR. DAVID CHAN
Credential	:
Telephone Number	:	832-945-2879

Provider Enumeration Date	:	08/25/2016
Last Update Date	:	08/25/2016

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