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NPI Code Detail

MEDICARE: MRS. GLORIA SR JOHN MSN

MEDICARE: MRS. GLORIA SR JOHN MSN
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
1251E00000XHome Health Agency
2374U00000XHome Health Aide

General Provider Information

NPI Number : 1740510718
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GLORIA SR JOHN MSN
Provider Business Mailing Address
First Line : 2330 WINNING COLORS
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78248-2515
Country : US
Telephone Number : 210-452-2077
Fax Number : 210-479-5740
Provider Business Practice Location Address
First Line : 2330 WINNING COLORS
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78248
Country : US
Telephone Number : 210-452-2077
Fax Number : 210-479-5740
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2010
Last Update Date : 01/13/2010

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