MEDICARE: KMD HEALTHCARE SERVICES INC

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	3416L0300X	Land Ambulance	1000787	TX

General Provider Information

NPI Number	:	1083988505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KMD HEALTHCARE SERVICES INC

Provider Business Mailing Address
First Line	:	13115 N BELLAIRE ESTATES DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-2393
Country	:	US
Telephone Number	:	832-782-3950
Fax Number	:	866-784-1461

Provider Business Practice Location Address
First Line	:	13115 N BELLAIRE ESTATES DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-2393
Country	:	US
Telephone Number	:	832-782-3950
Fax Number	:	866-784-1461

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MELVIN DAVIES
Credential	:
Telephone Number	:	832-782-3950

Provider Enumeration Date	:	03/01/2012
Last Update Date	:	03/03/2012

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