MEDICARE: GERIATRIC HOME CARE PHYSICIANS PA

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	363LA2200X	Adult Health Nurse Practitioner
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	L7979	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952348229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERIATRIC HOME CARE PHYSICIANS PA

Provider Business Mailing Address
First Line	:	PO BOX 17685
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77496-7685
Country	:	US
Telephone Number	:	281-565-1112
Fax Number	:	281-565-1102

Provider Business Practice Location Address
First Line	:	16605 SOUTHWEST FWY
Second Line	:	SUITE 175
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3501
Country	:	US
Telephone Number	:	281-565-1112
Fax Number	:	281-565-1102

Authorized Official
Title or Position	:	PRINCIPAL PARTNER
Name	:	ARUSHA A BAVARE
Credential	:	M.D.
Telephone Number	:	281-565-1112

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	02/12/2020

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Directions to “GERIATRIC HOME CARE PHYSICIANS PA ” Practice Location

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