MEDICARE: SYBLE MELINDA KONARIK

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1770106254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYBLE MELINDA KONARIK

Provider Business Mailing Address
First Line	:	317 PINE RIDGE DR
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-7112
Country	:	US
Telephone Number	:	936-402-0365
Fax Number	:

Provider Business Practice Location Address
First Line	:	233 COUNTY ROAD 2309
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-0276
Country	:	US
Telephone Number	:	936-402-0365
Fax Number	:

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

Provider Enumeration Date	:	05/19/2020
Last Update Date	:	05/19/2020

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Directions to “ SYBLE MELINDA KONARIK ” Practice Location

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