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NPI Code Detail

MEDICARE: WILLA BREWER

MEDICARE: WILLA BREWER
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
1172V00000XCommunity Health Worker
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1205571189
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLA BREWER
Provider Business Mailing Address
First Line : 6363 RICHMOND AVE STE 508
Second Line :
City : HOUSTON
State : TX
Zip : 77057-6129
Country : US
Telephone Number : 832-669-9926
Fax Number :
Provider Business Practice Location Address
First Line : 6363 RICHMOND AVE STE 508
Second Line :
City : HOUSTON
State : TX
Zip : 77057-6129
Country : US
Telephone Number : 832-669-9926
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2022
Last Update Date : 05/04/2022

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Directions to “ WILLA BREWER ” Practice Location

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