MEDICARE: 1ST ASSURANCE HEALTHCARE 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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1205764982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1ST ASSURANCE HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	810 HIGHWAY 6 S STE 111
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-4010
Country	:	US
Telephone Number	:	800-304-0750
Fax Number	:	346-620-3120

Provider Business Practice Location Address
First Line	:	810 HIGHWAY 6 S STE 111
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-4010
Country	:	US
Telephone Number	:	800-304-0750
Fax Number	:	346-620-3120

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MOJOLAOLUWA S LAWAL
Credential	:
Telephone Number	:	800-304-0750

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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