MEDICARE: PHYSICIAN HOUSE CALLS OF TEXAS LLC

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1750333423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN HOUSE CALLS OF TEXAS LLC

Provider Business Mailing Address
First Line	:	2400 HIGH RIDGE RD
Second Line	:	SUITE 101 AND 103
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8725
Country	:	US
Telephone Number	:	561-244-0220
Fax Number	:	561-244-0222

Provider Business Practice Location Address
First Line	:	6310 LBJ FWY
Second Line	:	SUITE 208
City	:	DALLAS
State	:	TX
Zip	:	75240-6401
Country	:	US
Telephone Number	:	214-221-1017
Fax Number	:	241-221-1019

Authorized Official
Title or Position	:	CEO
Name	:	MAXINE HOCHAUSER
Credential	:
Telephone Number	:	561-244-3601

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	05/15/2012

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