Provider Demographics
NPI:1053990143
Name:PRESTIGE HOME HEALTH LLC
Entity type:Organization
Organization Name:PRESTIGE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:SHANTAL
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-242-3710
Mailing Address - Street 1:7846 OAKINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2119
Mailing Address - Country:US
Mailing Address - Phone:832-242-3710
Mailing Address - Fax:281-310-6734
Practice Address - Street 1:7846 OAKINGTON DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2119
Practice Address - Country:US
Practice Address - Phone:832-242-3710
Practice Address - Fax:281-310-6734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32076688814Medicaid