MEDICARE: WOMEN'S HEALTH CARE CENTER, 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	261QA0005X	Ambulatory Family Planning Facility	558735	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164725412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOMEN'S HEALTH CARE CENTER, INC.

Provider Business Mailing Address
First Line	:	2914 S BUCKNER BLVD STE B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75227-6907
Country	:	US
Telephone Number	:	214-275-5256
Fax Number	:	214-275-5284

Provider Business Practice Location Address
First Line	:	2914 S BUCKNER BLVD STE B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75227-6907
Country	:	US
Telephone Number	:	214-275-5256
Fax Number	:	214-275-5284

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHERRY TENISON
Credential	:	APN
Telephone Number	:	214-275-5268

Provider Enumeration Date	:	12/08/2010
Last Update Date	:	12/08/2010

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