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	302R00000X	Health Maintenance Organization

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790826196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATWELL MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	6915 ATWELL DRIVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-6003
Country	:	US
Telephone Number	:	713-981-5777
Fax Number	:	713-981-8501

Provider Business Practice Location Address
First Line	:	6915 ATWELL DRIVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-6003
Country	:	US
Telephone Number	:	713-981-5777
Fax Number	:	713-981-8501

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. UCHE MCHENRY
Credential	:
Telephone Number	:	713-981-5777

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	07/17/2008

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