MEDICARE: HOUSTON SOUTHWEST

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	251S00000X	Community/Behavioral Health Agency		TX

General Provider Information

NPI Number	:	1922218130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON SOUTHWEST

Provider Business Mailing Address
First Line	:	9419 COMPTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77016-4805
Country	:	US
Telephone Number	:	713-330-3113
Fax Number	:	713-330-0037

Provider Business Practice Location Address
First Line	:	9419 COMPTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77016-4805
Country	:	US
Telephone Number	:	713-330-3113
Fax Number	:	713-330-0037

Authorized Official
Title or Position	:	CEO
Name	:	ROSA MAE ALSOBROOKS
Credential	:
Telephone Number	:	713-330-3113

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	08/22/2020

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Directions to “HOUSTON SOUTHWEST ” Practice Location

Language	Start Address	Practice Location

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