MEDICARE: PHOENIX FAMILY HEALTHCARE INC.

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	251E00000X	Home Health Agency	017556	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	017556	OTHER	TX	TEXAS DEPARTMENT OF AGING AND DISABILITY

General Provider Information

NPI Number	:	1174578561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX FAMILY HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	5625 CYPRESS CREEK PKWY STE 308
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4210
Country	:	US
Telephone Number	:	281-525-6020
Fax Number	:	281-525-6021

Provider Business Practice Location Address
First Line	:	5625 CYPRESS CREEK PKWY STE 308
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4210
Country	:	US
Telephone Number	:	291-525-6020
Fax Number	:	281-525-6021

Authorized Official
Title or Position	:	VICE PRESIDENT, BOARD OF DIRECTORS
Name	:	MARIE DAISY LOU TORREFRANCA ONG
Credential	:
Telephone Number	:	281-525-6020

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	03/21/2024

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