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General NPI Number Information
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NPI Number | 1306103007
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Entity Type | Organization
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Legal Business Name | EXCEL MINISTRIES' PROGRESSIVE WOMEN'S CENTER
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 04/18/2012
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Provider Practice Location Address
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Address Line | 8930 FOURWINDS DR STE. 251
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City | WINDCREST
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State | TX
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Zip | 78239-1970
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Country | US
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Telephone | 210-338-6580
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Fax |
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Provider Business Mailing Address
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Address Line | 8930 FOURWINDS DR STE. 251
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City | WINDCREST
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State | TX
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Zip | 78239-1970
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Country | US
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Telephone | 210-338-6580
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIE AL GLASTER JR.
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Credential | CBCB
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Telephone | 210-338-6580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 55096
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 55096
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License Number State | TX
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