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NPI Code Detail

MEDICARE: GUADALUPE JACOBO CAREGIVER

MEDICARE: GUADALUPE JACOBO CAREGIVER
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
1374U00000XHome Health Aide26135295TX

General Provider Information

NPI Number : 1831797059
Entity Type Code : Individual
Provider Name (Legal Business Name) : GUADALUPE JACOBO CAREGIVER
Provider Business Mailing Address
First Line : 8114 GLENSCOTT ST
Second Line :
City : HOUSTON
State : TX
Zip : 77061-2408
Country : US
Telephone Number : 832-815-9729
Fax Number :
Provider Business Practice Location Address
First Line : 5627 LAUREL CREEK WAY
Second Line :
City : HOUSTON
State : TX
Zip : 77017-6838
Country : US
Telephone Number : 832-374-9146
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2020
Last Update Date : 10/09/2020

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Directions to “ GUADALUPE JACOBO CAREGIVER” Practice Location

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