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General NPI Number Information
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NPI Number | 1386807659
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Entity Type | Organization
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Legal Business Name | MEDCARE CLINC
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 12834 WILLOW CTR STE E
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City | HOUSTON
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State | TX
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Zip | 77066-3047
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Country | US
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Telephone | 281-893-3656
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Fax | 281-896-3464
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Provider Business Mailing Address
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Address Line | 12834 WILLOW CTR STE E
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City | HOUSTON
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State | TX
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Zip | 77066-3047
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Country | US
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Telephone | 281-893-3656
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Fax | 281-896-3464
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Authorized Official
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Title or Position | OWNER
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Name | DR. IFEOMA N ARENE
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Credential | M.D.
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Telephone | 281-893-3656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | L5229
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License Number State | TX
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