MEDICARE: ATWELL MEDICAL CENTER INC

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1760511802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATWELL MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	6915 ATWELL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-6003
Country	:	US
Telephone Number	:	713-664-7800
Fax Number	:

Provider Business Practice Location Address
First Line	:	6915 ATWELL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-6003
Country	:	US
Telephone Number	:	713-664-7800
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. UCHE E. MCHENRY
Credential	:
Telephone Number	:	281-924-5344

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	12/09/2010

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