MEDICARE: AVALOS HEALTHCARE INC

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

General Provider Information

NPI Number	:	1801036488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVALOS HEALTHCARE INC

Provider Business Mailing Address
First Line	:	7300 BROMPTON ST APT 4521
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-2163
Country	:	US
Telephone Number	:	626-242-7138
Fax Number	:

Provider Business Practice Location Address
First Line	:	7300 BROMPTON ST APT 4521
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-2163
Country	:	US
Telephone Number	:	626-242-7138
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JONATHAN DAVID AVALOS
Credential	:
Telephone Number	:	626-242-7138

Provider Enumeration Date	:	02/23/2009
Last Update Date	:	02/23/2009

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