NPIMap

Organization Active NPI

Med-Source Homecare Services

  • In Home Supportive Care Agency
  • Sugar Land, TX
National Provider Identifier
1902144660
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
010184 Issued in TX
Legal business name
MED-SOURCE HOMECARE SERVICES
Practice address
12926 Dairy Ashford Rd
Suite 150
Sugar Land, TX 77478-3293
Phone
(281) 265-0095
NPI assigned
Jan 30, 2013
Last updated
Jan 30, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
MED-SOURCE HEALTHCARE SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Authorized official

Name
Ms. Priscilla Udeagha
Title
Adminstrator
Phone
(281) 265-0095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 010184 TX Primary

Addresses

Primary practice location

12926 Dairy Ashford Rd
Suite 150
Sugar Land, TX 77478-3293

Mailing address

12926 Dairy Ashford Rd
Suite 150
Sugar Land, TX 77478-3293
Phone (281) 265-0095

Other identifiers 1

IdentifierTypeStateIssuer
012116667MedicaidTX

Other names 1

  • med-Source Healthcare Services, Inc Former legal business name

National Provider Directory

National Provider Directory
Part of
Med-Source Healthcare Services Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359504000000",
    "number": "1902144660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12926 DAIRY ASHFORD RD",
            "address_2": "SUITE 150",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783293",
            "telephone_number": "281-265-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12926 DAIRY ASHFORD RD",
            "address_2": "SUITE 150",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783293",
            "telephone_number": "281-265-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-SOURCE HOMECARE SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MED-SOURCE HEALTHCARE SERVICES, INC",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A",
        "authorized_official_last_name": "UDEAGHA",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "281-265-0095",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TX",
            "license": "010184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012116667",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "med-Source Healthcare Services, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.