MEDICARE: ENVISION HEALTH CARE SERVICES, LLC

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	:	1891141255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENVISION HEALTH CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	23635 VERDE RIV
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78255-2033
Country	:	US
Telephone Number	:	210-284-6509
Fax Number	:

Provider Business Practice Location Address
First Line	:	23635 VERDE RIV
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78255-2033
Country	:	US
Telephone Number	:	210-284-6509
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEP
Name	:	MR. DAVID PAUL CORTEZ
Credential	:
Telephone Number	:	210-284-6509

Provider Enumeration Date	:	05/04/2016
Last Update Date	:	05/04/2016

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