MEDICARE: FERGUSON BUSINESS ASSOCIATES

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	251B00000X	Case Management Agency	22603	TX

General Provider Information

NPI Number	:	1194029017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FERGUSON BUSINESS ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 450068
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77245-0068
Country	:	US
Telephone Number	:	832-380-4423
Fax Number	:	713-434-2041

Provider Business Practice Location Address
First Line	:	3214 KNOTTY OAKS TRL
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-4518
Country	:	US
Telephone Number	:	832-380-4423
Fax Number	:	713-434-2041

Authorized Official
Title or Position	:	CHIEF OFFICER/DIRECTOR
Name	:	MRS. VERONICA F. SEIVWRIGHT
Credential	:	LMSW-IPR
Telephone Number	:	832-380-4423

Provider Enumeration Date	:	01/06/2011
Last Update Date	:	01/06/2011

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