Provider Demographics
NPI:1407440787
Name:PISTISCARE PEDIATRICS HOME HEALTH LLC
Entity Type:Organization
Organization Name:PISTISCARE PEDIATRICS HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-363-7764
Mailing Address - Street 1:2525 APPALOOSA LN
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-4690
Mailing Address - Country:US
Mailing Address - Phone:469-202-3045
Mailing Address - Fax:
Practice Address - Street 1:2525 APPALOOSA LN
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-4690
Practice Address - Country:US
Practice Address - Phone:469-202-3045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health