Provider Demographics
NPI:1205148004
Name:TERRY'S ANGEL HOME HEALTHCARE, INC
Entity type:Organization
Organization Name:TERRY'S ANGEL HOME HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CASMIR
Authorized Official - Middle Name:I
Authorized Official - Last Name:EGEMASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-650-7703
Mailing Address - Street 1:1117 COVINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-5489
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1117 COVINGTON DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-5489
Practice Address - Country:US
Practice Address - Phone:214-675-6491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health