Provider Demographics
NPI:1093862260
Name:OPTIMUM INC
Entity Type:Organization
Organization Name:OPTIMUM INC
Other - Org Name:OPTIMUM CARE HOME HEALTH AGENCY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:291-974-2075
Mailing Address - Street 1:8321 WOODWARD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77051-1329
Mailing Address - Country:US
Mailing Address - Phone:281-974-2075
Mailing Address - Fax:281-783-2282
Practice Address - Street 1:8321 WOODWARD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051-1329
Practice Address - Country:US
Practice Address - Phone:281-974-2075
Practice Address - Fax:281-783-2282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251G00000X, 251T00000X, 305R00000X
TX009007251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161606201OtherTPI
TX067115735Medicaid