MEDICARE: KOREAN HOME HEALTH CARE 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	253Z00000X	In Home Supportive Care Agency	012077	TX
2	251E00000X	Home Health Agency	012077	TX

General Provider Information

NPI Number	:	1205013257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KOREAN HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	1908 ROYAL LN STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-0263
Country	:	US
Telephone Number	:	972-241-9996
Fax Number	:	972-241-9997

Provider Business Practice Location Address
First Line	:	1908 ROYAL LN STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-0263
Country	:	US
Telephone Number	:	972-241-9996
Fax Number	:	972-241-9997

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SEOUNG JU RYOU
Credential	:	RN
Telephone Number	:	972-570-2417

Provider Enumeration Date	:	01/22/2008
Last Update Date	:	03/14/2025

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