Provider Demographics
NPI:1831226661
Name:HESTIE HOME HEALTH CARE
Entity type:Organization
Organization Name:HESTIE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-503-6441
Mailing Address - Street 1:12990 PANDORA DR
Mailing Address - Street 2:220
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-5220
Mailing Address - Country:US
Mailing Address - Phone:214-503-6441
Mailing Address - Fax:
Practice Address - Street 1:12990 PANDORA DR
Practice Address - Street 2:220
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-5220
Practice Address - Country:US
Practice Address - Phone:214-503-6441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677838Medicare Oscar/Certification