MEDICARE: DJ HEALTHCARE SERVICES INC

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	163WH0200X	Home Health Registered Nurse	002397	TX

General Provider Information

NPI Number	:	1265420558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DJ HEALTHCARE SERVICES INC

Provider Business Mailing Address
First Line	:	6633 N MESA ST
Second Line	:	#315
City	:	EL PASO
State	:	TX
Zip	:	79912-4427
Country	:	US
Telephone Number	:	915-845-7722
Fax Number	:	915-845-7723

Provider Business Practice Location Address
First Line	:	6633 N MESA ST
Second Line	:	#315
City	:	EL PASO
State	:	TX
Zip	:	79912-4427
Country	:	US
Telephone Number	:	915-845-7722
Fax Number	:	915-845-7723

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. JOANNE A BARRAZA
Credential	:
Telephone Number	:	915-845-7722

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	08/22/2020

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Directions to “DJ HEALTHCARE SERVICES INC ” Practice Location

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