MEDICARE: MOHAMMED KURTOM

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		TX

General Provider Information

NPI Number	:	1740672120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMMED KURTOM

Provider Business Mailing Address
First Line	:	7215 ROYAL GATE DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-5419
Country	:	US
Telephone Number	:	817-333-8799
Fax Number	:

Provider Business Practice Location Address
First Line	:	7215 ROYAL GATE DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-5419
Country	:	US
Telephone Number	:	817-333-8799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2015
Last Update Date	:	02/23/2015

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Directions to “ MOHAMMED KURTOM ” Practice Location

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