MEDICARE: THE PROMISE GROUP INC.

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		TX

General Provider Information

NPI Number	:	1306179049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PROMISE GROUP INC.

Provider Business Mailing Address
First Line	:	6314 WOOLWICH DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-7856
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6314 WOOLWICH DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-7856
Country	:	US
Telephone Number	:	817-465-3325
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ESTHER IBIANITOR EGBU
Credential	:	RN
Telephone Number	:	817-465-3325

Provider Enumeration Date	:	09/14/2009
Last Update Date	:	12/21/2009

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Directions to “THE PROMISE GROUP INC. ” Practice Location

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