- Enrollment id
- O20030204000007
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1174577183
- Multiple npi flag
- N
- Ccn
- 679267
- Associate id
- 3971412685
- Organization name
- MEDIGUARD AMERICA, INC.
- Doing business as name
- LONE STAR HOME HEALTH SERVICES
- Incorporation date
- 2002-10-08
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3129 ESTERS ROAD
- Address line 2
- SUITE 101
- City
- IRVING
- State
- TX
- Zip code
- 75062