MEDICARE: E & A HEALTH 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	:	1578847406
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E & A HEALTH SERVICES

Provider Business Mailing Address
First Line	:	5505 OAK GROVE RD W
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76134-2329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5505 OAK GROVE RD W
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76134-2329
Country	:	US
Telephone Number	:	817-615-8868
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANGELA JOHNSON
Credential	:
Telephone Number	:	817-615-8868

Provider Enumeration Date	:	10/11/2011
Last Update Date	:	10/11/2011

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Directions to “E & A HEALTH SERVICES ” Practice Location

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