MEDICARE: HOUSTON DIRECT 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1407405640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON DIRECT HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	1262 SEAMIST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-6146
Country	:	US
Telephone Number	:	386-290-6748
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 W 34TH ST UNIT 600
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-6264
Country	:	US
Telephone Number	:	713-568-5170
Fax Number	:

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER/OWNER
Name	:	MAHER CHEHAB
Credential	:
Telephone Number	:	386-290-6748

Provider Enumeration Date	:	09/10/2019
Last Update Date	:	09/10/2019

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