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NPI Code Detail

MEDICARE: CORPORATE SENIOR CENTER

MEDICARE: CORPORATE SENIOR CENTER
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
1311ZA0620XAdult Care Home Facility117648TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110014978OTHERTXAMERIGROUP ID

General Provider Information

NPI Number : 1114041811
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORPORATE SENIOR CENTER
Provider Business Mailing Address
First Line : 9630 CLAREWOOD DR STE A2
Second Line :
City : HOUSTON
State : TX
Zip : 77036-3535
Country : US
Telephone Number : 713-777-5123
Fax Number : 713-271-6689
Provider Business Practice Location Address
First Line : 9630 CLAREWOOD DR STE A2
Second Line :
City : HOUSTON
State : TX
Zip : 77036-3535
Country : US
Telephone Number : 713-777-5123
Fax Number : 713-271-6689
Authorized Official
Title or Position : ACTIVITY MANAGER
Name : SUSAN ZHAO
Credential :
Telephone Number : 281-380-8158
Provider Enumeration Date : 03/19/2007
Last Update Date : 03/16/2021

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Directions to “CORPORATE SENIOR CENTER ” Practice Location

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