MEDICARE: ELSIE EKWO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	343900000X	Non-emergency Medical Transport (VAN)
2	251B00000X	Case Management Agency
3	251E00000X	Home Health Agency
4	251S00000X	Community/Behavioral Health Agency
5	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1023477585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELSIE EKWO

Provider Business Mailing Address
First Line	:	6300 HILLCROFT ST STE 519
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-3009
Country	:	US
Telephone Number	:	713-396-9474
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 HILLCROFT ST STE 519
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-3009
Country	:	US
Telephone Number	:	713-396-9474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2016
Last Update Date	:	02/15/2016

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Directions to “ ELSIE EKWO ” Practice Location

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