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NPI Code Detail

MEDICARE: MEDCARE PEDIATRIC NURSING, LP

MEDICARE: MEDCARE PEDIATRIC NURSING, LP
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
1251J00000XNursing Care Agency010415TX
2251F00000XHome Infusion Agency010415TX
3251E00000XHome Health Agency010415TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2010415OTHERTXHOME & COMMUNITY SUPPORT SERVICES - LHH CATEGORY

General Provider Information

NPI Number : 1063452605
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDCARE PEDIATRIC NURSING, LP
Provider Business Mailing Address
First Line : 12371 S KIRKWOOD RD
Second Line :
City : STAFFORD
State : TX
Zip : 77477-2836
Country : US
Telephone Number : 713-995-9292
Fax Number : 713-995-4402
Provider Business Practice Location Address
First Line : 12371 S KIRKWOOD RD
Second Line :
City : STAFFORD
State : TX
Zip : 77477-2836
Country : US
Telephone Number : 713-995-9292
Fax Number : 713-995-4402
Authorized Official
Title or Position : CEO - ADMINISTRATOR
Name : MRS. PAIGE KINKADE
Credential :
Telephone Number : 713-995-9292
Provider Enumeration Date : 06/08/2006
Last Update Date : 05/29/2008

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1790839546 — CYNTHIA C EDMISTON SLP
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Directions to “MEDCARE PEDIATRIC NURSING, LP ” Practice Location

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