MEDICARE: KIARA DANIELS

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

General Provider Information

NPI Number	:	1295275618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIARA DANIELS

Provider Business Mailing Address
First Line	:	1506 AGENCY PT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78245-2924
Country	:	US
Telephone Number	:	832-929-0662
Fax Number	:	210-451-7493

Provider Business Practice Location Address
First Line	:	1506 AGENCY PT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78245-2924
Country	:	US
Telephone Number	:	832-929-0662
Fax Number	:	210-451-7493

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

Provider Enumeration Date	:	03/04/2017
Last Update Date	:	03/04/2017

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