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NPI Code Detail

MEDICARE: BREENA MAKEDA - KOBY

MEDICARE: BREENA MAKEDA - KOBY
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
1251E00000XHome Health Agency010801TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1010801OTHERTXLICENSE #
2011830OTHERTXCMS

General Provider Information

NPI Number : 1801975263
Entity Type Code : Organization
Provider Name (Legal Business Name) : BREENA MAKEDA - KOBY
Provider Business Mailing Address
First Line : 6105 BEVERLYHILL ST
Second Line : STE 102
City : HOUSTON
State : TX
Zip : 77057-6715
Country : US
Telephone Number : 713-974-6666
Fax Number : 713-974-6667
Provider Business Practice Location Address
First Line : 6105 BEVERLYHILL ST
Second Line : STE 102
City : HOUSTON
State : TX
Zip : 77057-6715
Country : US
Telephone Number : 713-974-6666
Fax Number : 713-974-6667
Authorized Official
Title or Position : DIRECTOR
Name : MS. BREENA I MAKEDA-KOBY
Credential : RN
Telephone Number : 713-974-6666
Provider Enumeration Date : 11/04/2006
Last Update Date : 05/17/2011

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Directions to “BREENA MAKEDA - KOBY ” Practice Location

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