MEDICARE: YOSNIEL OSVALDO GARCIA CRUZ

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	163W00000X	Registered Nurse	223923	TX
2	163WH0200X	Home Health Registered Nurse	980399	TX

General Provider Information

NPI Number	:	1265077887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOSNIEL OSVALDO GARCIA CRUZ

Provider Business Mailing Address
First Line	:	4527 WINDMILL RUN DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-2662
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4527 WINDMILL RUN DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-2662
Country	:	US
Telephone Number	:	512-542-4949
Fax Number	:

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

Provider Enumeration Date	:	11/07/2019
Last Update Date	:	02/25/2020

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