Provider Demographics
NPI:1467257063
Name:JOHN ETCHU DYNASTY HOMECARE SERVICES
Entity type:Organization
Organization Name:JOHN ETCHU DYNASTY HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:EBAI
Authorized Official - Last Name:ETCHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-584-7077
Mailing Address - Street 1:2522 BRIARBROOK LN
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-3900
Mailing Address - Country:US
Mailing Address - Phone:214-584-7077
Mailing Address - Fax:
Practice Address - Street 1:2522 BRIARBROOK LN
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-3900
Practice Address - Country:US
Practice Address - Phone:214-584-7077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health