MEDICARE: STAR OF DAVID HOME HEALTHCARE

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
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1396376778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAR OF DAVID HOME HEALTHCARE

Provider Business Mailing Address
First Line	:	3122 SPRINGDALE DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-5101
Country	:	US
Telephone Number	:	832-275-2686
Fax Number	:	866-292-3523

Provider Business Practice Location Address
First Line	:	3122 SPRINGDALE DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-5101
Country	:	US
Telephone Number	:	183-227-5268
Fax Number	:

Authorized Official
Title or Position	:	CEO FOUNDER
Name	:	MR. ISREAL CORNELIUS HOLMES
Credential	:
Telephone Number	:	832-275-2686

Provider Enumeration Date	:	02/04/2020
Last Update Date	:	02/16/2023

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Directions to “STAR OF DAVID HOME HEALTHCARE ” Practice Location

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