MEDICARE: PEMA HEALTHCARE 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	007132	TX

General Provider Information

NPI Number	:	1740213826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEMA HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	6200 SAVOY DR
Second Line	:	SUITE 731
City	:	HOUSTON
State	:	TX
Zip	:	77036-3300
Country	:	US
Telephone Number	:	713-266-5370
Fax Number	:	713-266-5539

Provider Business Practice Location Address
First Line	:	6200 SAVOY DR
Second Line	:	SUITE 731
City	:	HOUSTON
State	:	TX
Zip	:	77036-3300
Country	:	US
Telephone Number	:	713-266-5370
Fax Number	:	713-266-5539

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	PETER A ISHOLA
Credential	:
Telephone Number	:	713-266-5370

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	07/10/2008

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Directions to “PEMA HEALTHCARE SERVICES ” Practice Location

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