MEDICARE: ANGEL 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	103G00000X	Clinical Neuropsychologist		TX

General Provider Information

NPI Number	:	1356669295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL HEALTH, INC

Provider Business Mailing Address
First Line	:	8449 W BELLFORT ST STE 342
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2267
Country	:	US
Telephone Number	:	281-563-8915
Fax Number	:

Provider Business Practice Location Address
First Line	:	8449 W BELLFORT ST STE 342
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2267
Country	:	US
Telephone Number	:	281-563-8915
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MRS. ANN IGWILO
Credential	:
Telephone Number	:	281-536-8015

Provider Enumeration Date	:	05/15/2010
Last Update Date	:	12/08/2010

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Directions to “ANGEL HEALTH, INC ” Practice Location

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