Active NPI
Dynamic Healthcare Inc
- Home Health Agency
- Stafford, TX
National Provider Identifier
1760827695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Home Health Agency | 251E00000X | Primary | ||
| Nursing Care Agency | 251J00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Adult Companion | 372600000X | |||
| Personal Care Attendant | 3747P1801X | |||
| Home Health Aide | 374U00000X | |||
| Homemaker | 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2113495 | Dynamic Healthcare Inc | Certificate of waiver | May 23, 2028 |
National Provider Directory
National Provider DirectoryLocations
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.