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General NPI Number Information
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NPI Number | 1629580881
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Entity Type | Organization
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Legal Business Name | MEDICAL SPECIALIST
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Dates
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Enumeration Date | 10/27/2017
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 102 ASPEN ST
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City | LANCASTER
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State | TX
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Zip | 75134-3204
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Country | US
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Telephone | 972-740-7413
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Fax | 469-750-7317
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Provider Business Mailing Address
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Address Line | 102 ASPEN ST
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City | LANCASTER
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State | TX
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Zip | 75134-3204
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Country | US
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Telephone | 972-740-7413
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Fax | 469-750-7317
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Authorized Official
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Title or Position | DIEWCTOR
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Name | STEPHANIE YVETTE ROGERS
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Credential |
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Telephone | 972-740-7413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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