Organization Active NPI

Abundantly Living Home Care LLC

  • In Home Supportive Care Agency
  • Pearland, TX
National Provider Identifier
1104708924
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
ABUNDANTLY LIVING HOME CARE LLC
Practice address
11200 Broadway St Ste 2743
Pearland, TX 77584-9787
Phone
(713) 955-0967
Fax
(281) 262-3122
NPI assigned
Jul 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Samuel Willis, MDNPI 1396892410
Title
Owner
Phone
(713) 955-0967

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

11200 Broadway St Ste 2743
Pearland, TX 77584-9787

Mailing address

11200 Broadway St Ste 2743
Pearland, TX 77584-9787

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1104708924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 BROADWAY ST STE 2743",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775849787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 BROADWAY ST STE 2743",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775849787",
            "telephone_number": "713-955-0967",
            "fax_number": "281-262-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANTLY LIVING HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-955-0967",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.