MEDICARE: DEMIU 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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1912435025	OTHER	TX	NPPES

General Provider Information

NPI Number	:	1548739709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEMIU HOME HEALTHCARE

Provider Business Mailing Address
First Line	:	11911 STOUT OAK TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1460
Country	:	US
Telephone Number	:	512-886-1900
Fax Number	:	512-886-1901

Provider Business Practice Location Address
First Line	:	11911 STOUT OAK TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1460
Country	:	US
Telephone Number	:	512-886-1900
Fax Number	:	512-886-1901

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KERRIAN SMITH
Credential	:	RN
Telephone Number	:	254-206-1204

Provider Enumeration Date	:	11/16/2018
Last Update Date	:	07/26/2022

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Directions to “DEMIU HOME HEALTHCARE ” Practice Location

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