MEDICARE: MR. ALAIN R GAVIOLA

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	010120	TX

General Provider Information

NPI Number	:	1508903774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALAIN R GAVIOLA

Provider Business Mailing Address
First Line	:	3300 S GESSNER RD
Second Line	:	SUITE 125
City	:	HOUSTON
State	:	TX
Zip	:	77063-5100
Country	:	US
Telephone Number	:	713-781-2040
Fax Number	:	713-782-1136

Provider Business Practice Location Address
First Line	:	3300 S GESSNER RD
Second Line	:	SUITE 125
City	:	HOUSTON
State	:	TX
Zip	:	77063-5100
Country	:	US
Telephone Number	:	713-781-2040
Fax Number	:	713-782-1136

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	12/09/2008

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