MEDICARE: DEAVRA ARPEGE DAUGHTRY

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	005652	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982657565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEAVRA ARPEGE DAUGHTRY

Provider Business Mailing Address
First Line	:	9516 NORTH FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77037-1441
Country	:	US
Telephone Number	:	713-697-9235
Fax Number	:	713-697-9406

Provider Business Practice Location Address
First Line	:	9516 NORTH FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77037-1441
Country	:	US
Telephone Number	:	713-697-9235
Fax Number	:	713-697-9406

Authorized Official
Title or Position	:	CEO
Name	:	MS. DEAVRA DAUGHTRY
Credential	:
Telephone Number	:	713-697-9235

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	06/06/2008

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