MEDICARE: DOCTOR'S CHOICE HOME HEALTH

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	:	1609017250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTOR'S CHOICE HOME HEALTH

Provider Business Mailing Address
First Line	:	6047 BROADMEADOW
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-5308
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6047 BROADMEADOW
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-5308
Country	:	US
Telephone Number	:	210-216-5191
Fax Number	:

Authorized Official
Title or Position	:	GENERAL PARTNER
Name	:	MR. EDWARD VARGAS
Credential	:
Telephone Number	:	210-216-5191

Provider Enumeration Date	:	03/11/2009
Last Update Date	:	03/11/2009

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