Provider Demographics
NPI:1508133729
Name:VOLGA HOME CARE, LLC
Entity Type:Organization
Organization Name:VOLGA HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZAUR
Authorized Official - Middle Name:
Authorized Official - Last Name:GASANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-934-7060
Mailing Address - Street 1:10101 FONDREN RD STE 451
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4681
Mailing Address - Country:US
Mailing Address - Phone:713-923-2080
Mailing Address - Fax:888-817-4126
Practice Address - Street 1:10101 FONDREN RD STE 451
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096
Practice Address - Country:US
Practice Address - Phone:713-293-2080
Practice Address - Fax:888-817-4126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1508133729OtherNPI
TX345006601Medicaid