MEDICARE: QUENTIN JILES LMSW

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	104100000X	Social Worker	7231-S	NV

General Provider Information

NPI Number	:	1245880657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUENTIN JILES LMSW

Provider Business Mailing Address
First Line	:	4526 N RIPPLE RIDGE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77053-5302
Country	:	US
Telephone Number	:	281-299-7873
Fax Number	:

Provider Business Practice Location Address
First Line	:	4526 N RIPPLE RIDGE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77053-5302
Country	:	US
Telephone Number	:	281-299-7873
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2019
Last Update Date	:	09/17/2019

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Directions to “ QUENTIN JILES LMSW” Practice Location

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