MEDICARE: ATWELL MEDICAL GROUP

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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1760721518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATWELL MEDICAL GROUP

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	:	OWNER/FINANCE OFFICER
Name	:	MR. UCHE MCHENRY
Credential	:
Telephone Number	:	713-664-7800

Provider Enumeration Date	:	02/13/2013
Last Update Date	:	02/13/2013

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Directions to “ATWELL MEDICAL GROUP ” Practice Location

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