MEDICARE: KATRISKIA FILLS-BROWN

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1245771922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATRISKIA FILLS-BROWN

Provider Business Mailing Address
First Line	:	8900 GLENCREST ST
Second Line	:	#7276
City	:	HOUSTON
State	:	TX
Zip	:	77061-3070
Country	:	US
Telephone Number	:	832-245-0802
Fax Number	:

Provider Business Practice Location Address
First Line	:	8900 GLENCREST ST
Second Line	:	#7276
City	:	HOUSTON
State	:	TX
Zip	:	77061-3070
Country	:	US
Telephone Number	:	832-245-0802
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. KATRISKIA FILLS-BROWN
Credential	:
Telephone Number	:	832-245-0802

Provider Enumeration Date	:	03/15/2017
Last Update Date	:	03/15/2017

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