MEDICARE: MED FX HOME HEALTH AGENCY 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1275658155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED FX HOME HEALTH AGENCY LLC

Provider Business Mailing Address
First Line	:	PO BOX 382348
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75138-2348
Country	:	US
Telephone Number	:	214-809-1456
Fax Number	:

Provider Business Practice Location Address
First Line	:	6921 CLARK VISTA DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75236-5833
Country	:	US
Telephone Number	:	972-780-8202
Fax Number	:	972-709-9249

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSEFINA CUELLAR
Credential	:
Telephone Number	:	214-809-1456

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	08/22/2020

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