MEDICARE: THERAVIVE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1740087030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAVIVE CARE LLC

Provider Business Mailing Address
First Line	:	18126 SONORA BROOK LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1808
Country	:	US
Telephone Number	:	832-762-1194
Fax Number	:

Provider Business Practice Location Address
First Line	:	18126 SONORA BROOK LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1808
Country	:	US
Telephone Number	:	832-762-1194
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABDULWAHAB HAMMED ABDULWAHAB
Credential	:
Telephone Number	:	832-762-1194

Provider Enumeration Date	:	02/25/2025
Last Update Date	:	02/26/2025

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