MEDICARE: HD HOME HEALTHCARE AGENCY 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	:	1487236121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HD HOME HEALTHCARE AGENCY LLC

Provider Business Mailing Address
First Line	:	440 BENMAR DR STE 3332
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3172
Country	:	US
Telephone Number	:	281-529-6453
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 BENMAR DR STE 3332
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3172
Country	:	US
Telephone Number	:	281-529-6453
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	BEVERLY JOSEPH
Credential	:
Telephone Number	:	281-832-7243

Provider Enumeration Date	:	04/22/2021
Last Update Date	:	04/22/2021

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