MEDICARE: HOUSTON HOMECARE 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	251E00000X	Home Health Agency	015806	TX

General Provider Information

NPI Number	:	1376612762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON HOMECARE LLC

Provider Business Mailing Address
First Line	:	5450 NW CENTRAL DR
Second Line	:	STE. 110
City	:	HOUSTON
State	:	TX
Zip	:	77092-2017
Country	:	US
Telephone Number	:	713-956-6000
Fax Number	:	713-956-0902

Provider Business Practice Location Address
First Line	:	5450 NW CENTRAL DR
Second Line	:	STE. 110
City	:	HOUSTON
State	:	TX
Zip	:	77092-2017
Country	:	US
Telephone Number	:	713-956-6000
Fax Number	:	713-956-0902

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DAVID MORENO
Credential	:
Telephone Number	:	713-956-6000

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	04/12/2016

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