MEDICARE: AZA

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		TX

General Provider Information

NPI Number	:	1184079329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AZA

Provider Business Mailing Address
First Line	:	8422 ASH GARDEN CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-6522
Country	:	US
Telephone Number	:	832-230-6794
Fax Number	:

Provider Business Practice Location Address
First Line	:	8422 ASH GARDEN CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-6522
Country	:	US
Telephone Number	:	832-230-6794
Fax Number	:

Authorized Official
Title or Position	:	OWONER
Name	:	MR. ALFRED DWAYNE JOHNSON
Credential	:
Telephone Number	:	832-230-6794

Provider Enumeration Date	:	04/25/2016
Last Update Date	:	04/25/2016

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Directions to “AZA ” Practice Location

Language	Start Address	Practice Location

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