MEDICARE: DYNACARE HEALTH SOLUTIONS, 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	010592	TX

General Provider Information

NPI Number	:	1386741544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DYNACARE HEALTH SOLUTIONS, INC.

Provider Business Mailing Address
First Line	:	2646 SOUTH LOOP W
Second Line	:	SUITE 380
City	:	HOUSTON
State	:	TX
Zip	:	77054-2665
Country	:	US
Telephone Number	:	317-662-0300
Fax Number	:	713-668-9412

Provider Business Practice Location Address
First Line	:	2646 SOUTH LOOP W
Second Line	:	SUITE 380
City	:	HOUSTON
State	:	TX
Zip	:	77054-2665
Country	:	US
Telephone Number	:	317-662-0300
Fax Number	:	713-668-9412

Authorized Official
Title or Position	:	CEO
Name	:	MS. JULIET NWAKEJU NWOSU
Credential	:	LVN
Telephone Number	:	713-662-0300

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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