MEDICARE: TEXAS CARE OASIS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1053153981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS CARE OASIS, LLC

Provider Business Mailing Address
First Line	:	7906 MILLBROOK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-3976
Country	:	US
Telephone Number	:	832-338-7103
Fax Number	:

Provider Business Practice Location Address
First Line	:	15603 KUYKENDAHL RD # 321
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-3654
Country	:	US
Telephone Number	:	832-338-7103
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. EBONY KIMARIO
Credential	:
Telephone Number	:	832-338-7103

Provider Enumeration Date	:	06/11/2024
Last Update Date	:	06/11/2024

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Directions to “TEXAS CARE OASIS, LLC ” Practice Location

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