MEDICARE: CONSULTING HEALTHCARE EXECUTIVE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1073051132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONSULTING HEALTHCARE EXECUTIVE

Provider Business Mailing Address
First Line	:	1400 BROADFIELD BLVD
Second Line	:	STE 200
City	:	HOUSTON
State	:	TX
Zip	:	77084-5163
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 BROADFIELD BLVD
Second Line	:	STE 200
City	:	HOUSTON
State	:	TX
Zip	:	77084-5163
Country	:	US
Telephone Number	:	281-994-7847
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KELLY FRANCIS
Credential	:
Telephone Number	:	281-994-7847

Provider Enumeration Date	:	02/08/2017
Last Update Date	:	02/08/2017

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