MEDICARE: PRESTIGE HEALTH SERVICES,INC

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	251E00000X	Home Health Agency	009286	TX

General Provider Information

NPI Number	:	1154312361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESTIGE HEALTH SERVICES,INC

Provider Business Mailing Address
First Line	:	9888 BISSONNET ST
Second Line	:	STE. # 590
City	:	HOUSTON
State	:	TX
Zip	:	77036-8247
Country	:	US
Telephone Number	:	713-774-1195
Fax Number	:	713-774-1830

Provider Business Practice Location Address
First Line	:	9888 BISSONNET ST
Second Line	:	STE. # 590
City	:	HOUSTON
State	:	TX
Zip	:	77036-8247
Country	:	US
Telephone Number	:	713-774-1195
Fax Number	:	713-774-1830

Authorized Official
Title or Position	:	ALTERNATE ADMINISTRATOR
Name	:	MR. REUBEN AMAEFUNA NWOKOLO
Credential	:
Telephone Number	:	713-774-1195

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	08/31/2007

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