MEDICARE: CONSTANCE LOUISE OLIVEIRA

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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1073104261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONSTANCE LOUISE OLIVEIRA

Provider Business Mailing Address
First Line	:	23514 BAYLEAF DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-6277
Country	:	US
Telephone Number	:	281-408-5834
Fax Number	:

Provider Business Practice Location Address
First Line	:	23514 BAYLEAF DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-6277
Country	:	US
Telephone Number	:	281-408-5834
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2021
Last Update Date	:	01/29/2021

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Directions to “ CONSTANCE LOUISE OLIVEIRA ” Practice Location

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