Organization Active NPI

Optimom Healthcare LLC

  • In Home Supportive Care Agency
  • Houston, TX
National Provider Identifier
1730654021
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
OPTIMOM HEALTHCARE LLC
Doing business as
Optimom HealthCare LLC
Practice address
10101 Harwin Dr Ste 322
Houston, TX 77036-1686
Phone
(281) 513-0068
Fax
(281) 416-4735
NPI assigned
Oct 12, 2018
Last updated
Dec 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Authorized official

Name
Samuel L Bangura, OWNER
Title
Chief Financial Officer
Phone
(281) 905-8277

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU
Adult Care Home Facility 311ZA0620X NU
Personal Care Attendant 3747P1801X NU
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

10101 Harwin Dr Ste 322
Houston, TX 77036-1686

Mailing address

6119 Knollwest Dr
Houston, TX 77072-1021
Phone (832) 672-4903

Other identifiers 2

IdentifierTypeStateIssuer
HHS000004900867OtherTX001031105
648953782OtherTXSECRETARY OF STATE

Other names 1

  • Optimom HealthCare LLC Doing business as

National Provider Directory

National Provider Directory

Locations

10101 Harwin Dr
Ste 322
Houston, TX 77036
Phone (713) 777-6484

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1730654021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6119 KNOLLWEST DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770721021",
            "telephone_number": "832-672-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 HARWIN DR STE 322",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770361686",
            "telephone_number": "281-513-0068",
            "fax_number": "281-416-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMOM HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-12",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "BANGURA",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "281-905-8277",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "001031105",
            "identifier": "HHS000004900867",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECRETARY OF STATE",
            "identifier": "648953782",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimom HealthCare LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Optimom HealthCare LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.