MEDICARE: APPLE DEVELOPMENTAL HEALTH

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	208100000X	Physical Medicine & Rehabilitation Physician	104543	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	:	1063883478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPLE DEVELOPMENTAL HEALTH

Provider Business Mailing Address
First Line	:	1302 WAUGH DR
Second Line	:	#223
City	:	HOUSTON
State	:	TX
Zip	:	77019-3908
Country	:	US
Telephone Number	:	713-265-7919
Fax Number	:

Provider Business Practice Location Address
First Line	:	2712 ISABELLA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5446
Country	:	US
Telephone Number	:	713-265-7919
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	AKWETE HINES
Credential	:
Telephone Number	:	713-265-7919

Provider Enumeration Date	:	10/12/2015
Last Update Date	:	10/12/2015

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Directions to “APPLE DEVELOPMENTAL HEALTH ” Practice Location

Language	Start Address	Practice Location

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