MEDICARE: SOUTHEAST TEXAS FIRST ASSISTING 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	251J00000X	Nursing Care Agency	597248	TX

General Provider Information

NPI Number	:	1801032446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHEAST TEXAS FIRST ASSISTING SERVICES

Provider Business Mailing Address
First Line	:	17424 W GRAND PKWY # 122
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-2564
Country	:	US
Telephone Number	:	281-545-2066
Fax Number	:	281-857-6620

Provider Business Practice Location Address
First Line	:	17424 W GRAND PKWY # 122
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-2564
Country	:	US
Telephone Number	:	281-545-2066
Fax Number	:	281-857-6620

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. JODY G TRAHAN
Credential	:	RNFA
Telephone Number	:	409-673-1128

Provider Enumeration Date	:	01/04/2009
Last Update Date	:	01/04/2009

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