MEDICARE: SENIOR CARE SPECIALISTS 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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	L4440	OTHER	TX	MEDICAL LICENSE

General Provider Information

NPI Number	:	1952679409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR CARE SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	5617 BELMONT AVE
Second Line	:	SUITE 103-D
City	:	DALLAS
State	:	TX
Zip	:	75206-8713
Country	:	US
Telephone Number	:	214-824-3333
Fax Number	:	214-824-3131

Provider Business Practice Location Address
First Line	:	5617 BELMONT AVE
Second Line	:	SUITE 103-D
City	:	DALLAS
State	:	TX
Zip	:	75206-8713
Country	:	US
Telephone Number	:	214-824-3333
Fax Number	:	214-824-3131

Authorized Official
Title or Position	:	OWNER
Name	:	LAILA HIRJEE
Credential	:	MD
Telephone Number	:	214-824-3333

Provider Enumeration Date	:	12/12/2011
Last Update Date	:	12/12/2011

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Directions to “SENIOR CARE SPECIALISTS LLC ” Practice Location

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