MEDICARE: DKT HOMECARE SERVICES

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	:	1386968386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DKT HOMECARE SERVICES

Provider Business Mailing Address
First Line	:	5029 LINCOLN OAKS DR S
Second Line	:	1401
City	:	FORT WORTH
State	:	TX
Zip	:	76132-2288
Country	:	US
Telephone Number	:	817-386-3128
Fax Number	:	817-370-1153

Provider Business Practice Location Address
First Line	:	5029 LINCOLN OAKS DR S
Second Line	:	1401
City	:	FORT WORTH
State	:	TX
Zip	:	76132-2288
Country	:	US
Telephone Number	:	817-386-3128
Fax Number	:	817-370-1153

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TENIQUA MAYES
Credential	:
Telephone Number	:	817-386-3128

Provider Enumeration Date	:	03/18/2010
Last Update Date	:	03/18/2010

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