Provider Demographics
NPI:1104150531
Name:SIGNATURE HOMECARE SERVICES, TEXAS LLC
Entity type:Organization
Organization Name:SIGNATURE HOMECARE SERVICES, TEXAS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ABITURAB 'ABI'
Authorized Official - Middle Name:
Authorized Official - Last Name:BOXWALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-825-4060
Mailing Address - Street 1:7820 GRAPHIC DR STE 201
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-6278
Mailing Address - Country:US
Mailing Address - Phone:708-307-8048
Mailing Address - Fax:773-685-9066
Practice Address - Street 1:8300 CYPRESS CREEK PKWY STE 350
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5699
Practice Address - Country:US
Practice Address - Phone:832-237-5800
Practice Address - Fax:832-237-5810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10379251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679628Medicare Oscar/Certification