Provider Demographics
NPI:1457665317
Name:PEDIATRIC HOME HEALTHCARE, LLC
Entity type:Organization
Organization Name:PEDIATRIC HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-630-4810
Mailing Address - Street 1:17950 PRESTON RD STE 370
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-6205
Mailing Address - Country:US
Mailing Address - Phone:972-630-4811
Mailing Address - Fax:
Practice Address - Street 1:18601 LBJ FWY STE 723
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6436
Practice Address - Country:US
Practice Address - Phone:972-630-4811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health