MEDICARE: STRAIGHT DEFINED

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	:	1265932990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRAIGHT DEFINED

Provider Business Mailing Address
First Line	:	208 W LINCOLN AVE
Second Line	:
City	:	COPPERAS COVE
State	:	TX
Zip	:	76522-1617
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	208 W LINCOLN AVE
Second Line	:
City	:	COPPERAS COVE
State	:	TX
Zip	:	76522-1617
Country	:	US
Telephone Number	:	254-577-1042
Fax Number	:

Authorized Official
Title or Position	:	OWNER/FOUNDER
Name	:	DYNASTY HOLLAND
Credential	:
Telephone Number	:	254-577-1042

Provider Enumeration Date	:	02/19/2018
Last Update Date	:	06/16/2018

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Directions to “STRAIGHT DEFINED ” Practice Location

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