MEDICARE: T & T HOME HEALTH AGENCY

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	008910	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HH245H	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1659404648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	T & T HOME HEALTH AGENCY

Provider Business Mailing Address
First Line	:	3530 FOREST LN STE 265
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-7970
Country	:	US
Telephone Number	:	972-726-9945
Fax Number	:	214-350-4999

Provider Business Practice Location Address
First Line	:	3530 FOREST LN STE 265
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-7970
Country	:	US
Telephone Number	:	972-726-9945
Fax Number	:	214-350-4999

Authorized Official
Title or Position	:	ADMINITRATOR/ OWNER
Name	:	MRS. FLORENCE UREVBU
Credential	:
Telephone Number	:	972-726-9945

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	01/08/2008

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Directions to “T & T HOME HEALTH AGENCY ” Practice Location

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