Organization Active NPI

Dynamic Healthcare Inc

  • Home Health Agency
  • Stafford, TX
National Provider Identifier
1760827695
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
DYNAMIC HEALTHCARE INC
Practice address
4418 Bluebonnet Drive
Suite 209
Stafford, TX 77477
Phone
(832) 886-4179
Fax
(281) 944-5682
NPI assigned
May 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Miss Clementina Amaoge Williamson
Title
Administrator/Owner
Phone
(713) 517-4492

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Home Health Agency 251E00000X Primary
Nursing Care Agency 251J00000X
In Home Supportive Care Agency 253Z00000X
Adult CompanionGroup: 193200000X MULTI-SPECIALTY GROUP 372600000X
Personal Care AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 3747P1801X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X
HomemakerGroup: 193200000X MULTI-SPECIALTY GROUP 376J00000X

Addresses

Primary practice location

4418 Bluebonnet Drive
Suite 209
Stafford, TX 77477

Mailing address

4418 Bluebonnet Dr Ste 209
Stafford, TX 77477-2904
Phone (832) 886-4179

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2113495Dynamic Healthcare Inc4418 Bluebonnet Dr Suite 209, Stafford, TX 77477Certificate of waiverMay 23, 2028

National Provider Directory

National Provider Directory

Locations

4418 Bluebonnet Dr
Ste 209
Stafford, TX 77477
Phone (832) 886-4179

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1760827695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4418 BLUEBONNET DR STE 209",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774772904",
            "telephone_number": "832-886-4179",
            "fax_number": "281-944-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4418 BLUEBONNET DRIVE",
            "address_2": "SUITE 209",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "77477",
            "telephone_number": "832-886-4179",
            "fax_number": "281-944-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-06",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "CLEMENTINA",
        "authorized_official_middle_name": "AMAOGE",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "713-517-4492",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.