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General NPI Number Information
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NPI Number | 1932432614
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Entity Type | Organization
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Legal Business Name | GMW HEALTH
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Dates
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Enumeration Date | 09/11/2009
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Last Update Date | 09/11/2009
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Provider Practice Location Address
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Address Line | 14310 CASHEL FOREST DR
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City | HOUSTON
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State | TX
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Zip | 77069-3514
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Country | US
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Telephone | 281-397-6745
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Fax | 936-372-9013
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Provider Business Mailing Address
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Address Line | 14310 CASHEL FOREST DR
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City | HOUSTON
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State | TX
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Zip | 77069-3514
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Country | US
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Telephone | 281-397-6745
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Fax | 936-372-9013
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MS. GERALDINE WILSON
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Credential | FNP-C
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Telephone | 281-397-6745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 641578
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License Number State | TX
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