MEDICARE: WEECARE THERAPY SERVICES

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	235Z00000X	Speech-Language Pathologist	100623	TX
2	2251P0200X	Pediatric Physical Therapist	1047058	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

General Provider Information

NPI Number	:	1285907360
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEECARE THERAPY SERVICES

Provider Business Mailing Address
First Line	:	14511 LAKESIDE TERRACE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-5292
Country	:	US
Telephone Number	:	713-417-2783
Fax Number	:	281-436-0550

Provider Business Practice Location Address
First Line	:	14511 LAKESIDE TERRACE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-5292
Country	:	US
Telephone Number	:	713-417-2783
Fax Number	:	281-436-0550

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MONIQUE STAATS BELL
Credential	:	PHYSICAL THERAPIST
Telephone Number	:	713-417-2783

Provider Enumeration Date	:	02/20/2012
Last Update Date	:	02/20/2012

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Directions to “WEECARE THERAPY SERVICES ” Practice Location

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