MEDICARE: CAMERON QUALITY CARE, 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	:	1558617639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMERON QUALITY CARE, LLC

Provider Business Mailing Address
First Line	:	1341 W 43RD ST
Second Line	:	SUITE 112
City	:	HOUSTON
State	:	TX
Zip	:	77018-4205
Country	:	US
Telephone Number	:	832-744-1087
Fax Number	:

Provider Business Practice Location Address
First Line	:	1341 W 43RD ST
Second Line	:	SUITE 112
City	:	HOUSTON
State	:	TX
Zip	:	77018-4205
Country	:	US
Telephone Number	:	832-744-1087
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CRYSTAL L GIDREY
Credential	:
Telephone Number	:	832-744-1087

Provider Enumeration Date	:	07/26/2012
Last Update Date	:	07/26/2012

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