MEDICARE: TEJAS QUALITY HOME HEALTHCARE INC.

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	5403	TX
2	251G00000X	Community Based Hospice Care Agency	5403	TX

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700861960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEJAS QUALITY HOME HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	8900 EMMETT F LOWRY EXPY
Second Line	:	SUITE 104
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-9116
Country	:	US
Telephone Number	:	409-935-7925
Fax Number	:	409-935-7926

Provider Business Practice Location Address
First Line	:	4903 GOLDEN QUAIL
Second Line	:	SUITE 110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1584
Country	:	US
Telephone Number	:	210-734-7333
Fax Number	:	210-734-8775

Authorized Official
Title or Position	:	CEO
Name	:	WALTER F CROWDER
Credential	:
Telephone Number	:	409-935-1234

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	08/17/2016

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Directions to “TEJAS QUALITY HOME HEALTHCARE INC. ” Practice Location

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