| Provista Healthcare | |
|
4849 Greenville Ave 1124 Dallas TX 75206-4130 | |
| (214) 965-0431 | |
| (214) 965-0434 |
| Full Name | Provista Healthcare |
|---|---|
| Speciality | Home Health |
| Location | 4849 Greenville Ave, Dallas, Texas |
| Authorized Official Name and Position | Melissa Rodriguez (ADMINISTRATOR) |
| Authorized Official Contact | 8889650431 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Provista Healthcare 4849 Greenville Ave 1124 Dallas TX 75206-4130 Ph: (214) 965-0431 | Provista Healthcare 4849 Greenville Ave 1124 Dallas TX 75206-4130 Ph: (214) 965-0431 |
| NPI Number | 1568446185 |
|---|---|
| Provider Enumeration Date | 12/06/2005 |
| Last Update Date | 04/03/2024 |
| Certification Date | 04/03/2024 |
| Medicare PECOS PAC ID | 6709869894 |
|---|---|
| Medicare Enrollment ID | O20040610000172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568446185 | NPI | - | NPPES |
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