MEDICARE: MEDORA LIFE CARE 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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1780500751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDORA LIFE CARE LLC

Provider Business Mailing Address
First Line	:	5600 BERKLEY KNOLL CIR APT 10102
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-3347
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5600 BERKLEY KNOLL CIR APT 10102
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-3347
Country	:	US
Telephone Number	:	432-243-4243
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SYED ANAS
Credential	:
Telephone Number	:	432-243-4243

Provider Enumeration Date	:	06/25/2026
Last Update Date	:	06/25/2026

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Directions to “MEDORA LIFE CARE LLC ” Practice Location

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