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General NPI Number Information
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NPI Number | 1649756420
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Entity Type | Organization
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Legal Business Name | MEDICAL ENVISION,INC.
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 07/16/2018
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Provider Practice Location Address
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Address Line | 5001 WILLIFORD RD
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City | SACHSE
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State | TX
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Zip | 75048
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Country | US
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Telephone | 972-495-6929
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Fax |
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Provider Business Mailing Address
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Address Line | 5001 WILLIFORD RD
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City | SACHSE
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State | TX
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Zip | 75048-3378
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Country | US
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Telephone | 214-934-0768
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ELIZABETH PASCUAL SRIVASTAVA
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Credential | MD
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Telephone | 972-495-6929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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License Number | G0869
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License Number State | TX
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