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General NPI Number Information
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NPI Number | 1871751453
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Entity Type | Organization
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Legal Business Name | LEO CAPRI INC
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 835 SW ALSBURY BLVD SUITE ,J,
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City | BURLESON
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State | TX
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Zip | 76028-4093
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Country | US
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Telephone | 817-920-0800
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Fax | 817-920-0801
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Provider Business Mailing Address
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Address Line | 835 SW ALSBURY BLVD SUITE ,J,
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City | BURLESON
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State | TX
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Zip | 76028-4093
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Country | US
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Telephone | 817-920-0800
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Fax | 817-920-0801
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Authorized Official
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Title or Position | ADM/D.O.N
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Name | MRS. PUSHPAM SWAMY MYDUR
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Credential | RNC,ANP
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Telephone | 817-689-1289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 011966
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License Number State | TX
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