- Enrollment id
- O20050727000621
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1245364686
- Multiple npi flag
- N
- Ccn
- 677946
- Associate id
- 7315975893
- Organization name
- D J MONTGOMERY ENTERPRISE, LLC
- Doing business as name
- PHYSICIANS CHOICE HEALTH SERVICES
- Incorporation date
- 2004-11-16
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 860 HEBRON PARKWAY
- Address line 2
- SUITE 703 & 704
- City
- LEWISVILLE
- State
- TX
- Zip code
- 750575145