MEDICARE: SOURCE FOR WOMEN OF HOUSTON INC CARE NET PREGNANCY CENTER OF HOUSTON

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1538421201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOURCE FOR WOMEN OF HOUSTON INC CARE NET PREGNANCY CENTER OF HOUSTON

Provider Business Mailing Address
First Line	:	6009 RICHMOND AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-6226
Country	:	US
Telephone Number	:	713-780-0030
Fax Number	:	877-874-2816

Provider Business Practice Location Address
First Line	:	6009 RICHMOND AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-6226
Country	:	US
Telephone Number	:	713-780-0030
Fax Number	:	877-874-2816

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	CYNTHIA WENZ
Credential	:
Telephone Number	:	713-780-0030

Provider Enumeration Date	:	06/08/2012
Last Update Date	:	06/08/2012

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