MEDICARE: TENDER LOVING CARE

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	311ZA0620X	Adult Care Home Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598388795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDER LOVING CARE

Provider Business Mailing Address
First Line	:	167 KOEPSEL RD
Second Line	:
City	:	MC QUEENEY
State	:	TX
Zip	:	78123-3535
Country	:	US
Telephone Number	:	830-557-8341
Fax Number	:

Provider Business Practice Location Address
First Line	:	167 KOEPSEL RD
Second Line	:
City	:	MC QUEENEY
State	:	TX
Zip	:	78123-3535
Country	:	US
Telephone Number	:	830-557-8341
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LOUISA MENDEZ
Credential	:
Telephone Number	:	830-557-8341

Provider Enumeration Date	:	05/21/2020
Last Update Date	:	05/21/2020

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Directions to “TENDER LOVING CARE ” Practice Location

Language	Start Address	Practice Location

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