Organization · NPI-2

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Home Health · Arlington, TX

NPI number1124302658
StatusActive
Last updated in NPPESOct 3, 2011

Details

NPI
1124302658
Entity type
Organization (NPI-2)
Legal business name
99999999
Organization subpart
No
Enumeration date
Oct 3, 2011
Last updated
Oct 3, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health2014064TXYes

Practice location

5203 Wild Horse Ct
Arlington, TX 76017-2074

Phone 817-793-0172

Mailing address

5203 Wild Horse Ct
Arlington, TX 76017-2074

Phone 817-793-0172

Authorized official

Gary Wayne Patterson
Pta
8177930172

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