MEDICARE: LEI-KARES HEALTH 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	363LF0000X	Family Nurse Practitioner	AP125623	TX

General Provider Information

NPI Number	:	1194178848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEI-KARES HEALTH INC

Provider Business Mailing Address
First Line	:	19811 FAIRGRANGE PLACE LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-3406
Country	:	US
Telephone Number	:	713-391-0900
Fax Number	:

Provider Business Practice Location Address
First Line	:	7514 KINGSLEY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087-4412
Country	:	US
Telephone Number	:	713-391-0900
Fax Number	:	281-819-3334

Authorized Official
Title or Position	:	OWNER
Name	:	EVALYNE ONGORI
Credential	:	FNP
Telephone Number	:	713-391-0900

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	07/18/2016

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