MEDICARE: HOUSTON'S AMAZING PLACE

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	385H00000X	Respite Care	126905	TX

General Provider Information

NPI Number	:	1154610053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON'S AMAZING PLACE

Provider Business Mailing Address
First Line	:	3735 DREXEL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-6896
Country	:	US
Telephone Number	:	713-552-0420
Fax Number	:	713-552-0165

Provider Business Practice Location Address
First Line	:	3735 DREXEL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-6896
Country	:	US
Telephone Number	:	713-552-0420
Fax Number	:	713-552-0165

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. TRACEY DOSS BROWN
Credential	:
Telephone Number	:	713-552-0420

Provider Enumeration Date	:	03/31/2011
Last Update Date	:	03/31/2011

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