MEDICARE: ANGEL WINGS HOME HEALTH CARE AGENCY

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	:	1144332347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL WINGS HOME HEALTH CARE AGENCY

Provider Business Mailing Address
First Line	:	7303 LAS BRISAS DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-4325
Country	:	US
Telephone Number	:	281-495-2937
Fax Number	:	281-879-7937

Provider Business Practice Location Address
First Line	:	7303 LAS BRISAS DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-4325
Country	:	US
Telephone Number	:	281-495-2937
Fax Number	:	281-879-7937

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. GINA R. MOORE
Credential	:	RN
Telephone Number	:	281-495-2937

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	06/18/2008

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