MEDICARE: KCT HOMECARE LLC

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	:	1366638314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KCT HOMECARE LLC

Provider Business Mailing Address
First Line	:	701 BRAZOS ST
Second Line	:	SUITE 500 MB 51
City	:	AUSTIN
State	:	TX
Zip	:	78701-3258
Country	:	US
Telephone Number	:	512-320-9199
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 BRAZOS ST
Second Line	:	SUITE 500 MB 51
City	:	AUSTIN
State	:	TX
Zip	:	78701-3258
Country	:	US
Telephone Number	:	512-320-9199
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MR. KYLE A TURNER
Credential	:
Telephone Number	:	512-320-9199

Provider Enumeration Date	:	09/23/2007
Last Update Date	:	09/23/2007

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