MEDICARE: CESAR CONTRERAS OWNER

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	009729	TX

General Provider Information

NPI Number	:	1275546459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CESAR CONTRERAS OWNER

Provider Business Mailing Address
First Line	:	2248 GUS THOMASSON
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-3003
Country	:	US
Telephone Number	:	214-823-9960
Fax Number	:	214-823-6832

Provider Business Practice Location Address
First Line	:	2248 GUS THOMASSON
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-3003
Country	:	US
Telephone Number	:	214-823-9960
Fax Number	:	214-823-6832

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	11/08/2007

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Directions to “ CESAR CONTRERAS OWNER” Practice Location

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