MEDICARE: KNV THERAPY HOME SERVICES 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	174400000X	Specialist		TX

General Provider Information

NPI Number	:	1427403112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNV THERAPY HOME SERVICES LLC

Provider Business Mailing Address
First Line	:	2505 LAS BRISAS ST
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-5015
Country	:	US
Telephone Number	:
Fax Number	:	361-452-0697

Provider Business Practice Location Address
First Line	:	2505 LAS BRISAS ST
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-5015
Country	:	US
Telephone Number	:	774-207-8983
Fax Number	:	361-452-0697

Authorized Official
Title or Position	:	PHYSICAL THERAPIST/OWNER
Name	:	KAREN ESTREMOS
Credential	:	PT, DPT
Telephone Number	:	361-929-7797

Provider Enumeration Date	:	04/30/2016
Last Update Date	:	04/30/2016

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