MEDICARE: DA LUIS HOME CARE 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	N/A	TX
2	251E00000X	Home Health Agency	013820	TX

General Provider Information

NPI Number	:	1437465960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DA LUIS HOME CARE LLC

Provider Business Mailing Address
First Line	:	14525 FM 529 STE. 104
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-3596
Country	:	US
Telephone Number	:	281-855-2300
Fax Number	:	281-855-2310

Provider Business Practice Location Address
First Line	:	14525 FM 529 STE. 104
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-3596
Country	:	US
Telephone Number	:	281-855-2300
Fax Number	:	281-855-2310

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR/SUPERVISING NUR
Name	:	MRS. SHIRRA ANNE HERRON
Credential	:	RN
Telephone Number	:	281-855-2300

Provider Enumeration Date	:	08/22/2010
Last Update Date	:	01/04/2012

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Directions to “DA LUIS HOME CARE LLC ” Practice Location

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