Provider Demographics
NPI:1386723096
Name:MYNURSE HOME CARE INC
Entity type:Organization
Organization Name:MYNURSE HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYS
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:713-436-0999
Mailing Address - Street 1:4005 TECHNOLOGY RD # 2190
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-2556
Mailing Address - Country:US
Mailing Address - Phone:713-436-0999
Mailing Address - Fax:713-340-0676
Practice Address - Street 1:4005 TECHNOLOGY RD # 2190
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-2556
Practice Address - Country:US
Practice Address - Phone:713-436-0999
Practice Address - Fax:713-340-0676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D1065283OtherCLIA
TX218716301Medicaid