MEDICARE: AVISTAR HOME HEALTH AGENCY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3747P1801X	Personal Care Attendant
2	3747A0650X	Attendant Care Provider
3	253Z00000X	In Home Supportive Care Agency
4	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1891460325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVISTAR HOME HEALTH AGENCY

Provider Business Mailing Address
First Line	:	1517 CAYMUS CT
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-3254
Country	:	US
Telephone Number	:	214-430-0996
Fax Number	:	833-414-0604

Provider Business Practice Location Address
First Line	:	2201 SPINKS RD STE 133
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-4451
Country	:	US
Telephone Number	:	214-430-0996
Fax Number	:	833-414-0604

Authorized Official
Title or Position	:	ADMINISTRATOR ASSISTANT
Name	:	ROSE EFESOA
Credential	:
Telephone Number	:	214-430-0996

Provider Enumeration Date	:	08/16/2021
Last Update Date	:	03/03/2026

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