Provider Demographics
NPI:1891229803
Name:HEALTHY SENIORS AT HOME HOUSE CALLS, PLLC
Entity Type:Organization
Organization Name:HEALTHY SENIORS AT HOME HOUSE CALLS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:870-703-5022
Mailing Address - Street 1:1459 VZ COUNTY ROAD 3210
Mailing Address - Street 2:
Mailing Address - City:WILLS POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75169-7103
Mailing Address - Country:US
Mailing Address - Phone:870-703-5022
Mailing Address - Fax:
Practice Address - Street 1:1459 VZ COUNTY ROAD 3210
Practice Address - Street 2:
Practice Address - City:WILLS POINT
Practice Address - State:TX
Practice Address - Zip Code:75169-7103
Practice Address - Country:US
Practice Address - Phone:870-703-5022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126170364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontologyGroup - Single Specialty