MEDICARE: MY HEALTHY ACCESS PROVIDERS, PLLC

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1184897373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY HEALTHY ACCESS PROVIDERS, PLLC

Provider Business Mailing Address
First Line	:	2500 WOODLAND PARK DR
Second Line	:	C204
City	:	HOUSTON
State	:	TX
Zip	:	77077-2271
Country	:	US
Telephone Number	:	281-759-6868
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 WOODLAND PARK DR
Second Line	:	C204
City	:	HOUSTON
State	:	TX
Zip	:	77077-2271
Country	:	US
Telephone Number	:	281-759-6868
Fax Number	:

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MR. TONEY EARL MEANS
Credential	:
Telephone Number	:	281-759-6868

Provider Enumeration Date	:	04/08/2008
Last Update Date	:	04/08/2008

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