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General NPI Number Information
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NPI Number | 1710497367
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Entity Type | Individual
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Provider Name | MICHAEL BREWER
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Gender | Male
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 10/10/2017
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Provider Practice Location Address
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Address Line | 363 N SAM HOUSTON PKWY E
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City | HOUSTON
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State | TX
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Zip | 77060-2404
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Country | US
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Telephone | 281-405-2614
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Fax |
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Provider Business Mailing Address
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Address Line | 9022 SAINT LAURENT LN
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City | HOUSTON
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State | TX
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Zip | 77044-1934
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Country | US
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Telephone | 832-296-9634
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 018215
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License Number State | TX
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