MEDICARE: GREEN-DORSEY ENTERPRISES

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	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1699154369	OTHER	TX	HOME CARE

General Provider Information

NPI Number	:	1912565458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREEN-DORSEY ENTERPRISES

Provider Business Mailing Address
First Line	:	5870 HIGHWAY 6 N STE 315
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-1857
Country	:	US
Telephone Number	:	281-849-1949
Fax Number	:	832-442-3394

Provider Business Practice Location Address
First Line	:	5870 HIGHWAY 6 N STE 315
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-1857
Country	:	US
Telephone Number	:	281-849-1949
Fax Number	:	832-442-3394

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOHN F GREEN
Credential	:
Telephone Number	:	832-748-8775

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	05/30/2019

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Directions to “GREEN-DORSEY ENTERPRISES ” Practice Location

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