MEDICARE: KQ NEURO TEAM 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	:	1548939036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KQ NEURO TEAM LLC

Provider Business Mailing Address
First Line	:	4005 RUFE SNOW DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8845
Country	:	US
Telephone Number	:	682-238-1797
Fax Number	:

Provider Business Practice Location Address
First Line	:	4005 RUFE SNOW DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8845
Country	:	US
Telephone Number	:	682-238-1797
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TRACIE SIMPSON
Credential	:	APRN
Telephone Number	:	817-841-0829

Provider Enumeration Date	:	09/08/2021
Last Update Date	:	03/24/2025

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