Provider Demographics
NPI:1922251487
Name:DEVOTED HEALTHCARE AT HOME, LLC
Entity Type:Organization
Organization Name:DEVOTED HEALTHCARE AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:214-662-9893
Mailing Address - Street 1:2809 SAN FELIPE DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-0351
Mailing Address - Country:US
Mailing Address - Phone:940-381-6908
Mailing Address - Fax:940-381-6908
Practice Address - Street 1:2809 SAN FELIPE DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0351
Practice Address - Country:US
Practice Address - Phone:940-381-6908
Practice Address - Fax:940-381-6908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX630478174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty