MEDICARE: PROF. EVELYNE HART RN

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	163WH0200X	Home Health Registered Nurse	238045	TX

General Provider Information

NPI Number	:	1255701868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. EVELYNE HART RN

Provider Business Mailing Address
First Line	:	16354 ELLA BLVD
Second Line	:	#2104
City	:	HOUSTON
State	:	TX
Zip	:	77090-4605
Country	:	US
Telephone Number	:	281-455-0088
Fax Number	:	832-602-5177

Provider Business Practice Location Address
First Line	:	16354 ELLA BLVD
Second Line	:	#2104
City	:	HOUSTON
State	:	TX
Zip	:	77090-4605
Country	:	US
Telephone Number	:	281-455-0088
Fax Number	:	832-602-5177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2015
Last Update Date	:	09/25/2015

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