MEDICARE: TEP PRODUCTIONS

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1073964896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEP PRODUCTIONS

Provider Business Mailing Address
First Line	:	4265 CHEVY CHASE LN
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75033-4484
Country	:	US
Telephone Number	:	310-795-9066
Fax Number	:

Provider Business Practice Location Address
First Line	:	4265 CHEVY CHASE LN
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75033-4484
Country	:	US
Telephone Number	:	310-795-9066
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MATTHEW PRINCIOTTO
Credential	:
Telephone Number	:	310-795-9066

Provider Enumeration Date	:	06/22/2016
Last Update Date	:	06/22/2016

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Directions to “TEP PRODUCTIONS ” Practice Location

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