MEDICARE: WES HEALTHCARE 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	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1386876357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WES HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	6100 ELM ST APT 1401
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-3309
Country	:	US
Telephone Number	:	713-244-4565
Fax Number	:	713-777-5205

Provider Business Practice Location Address
First Line	:	6100 ELM ST APT 1402
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-3309
Country	:	US
Telephone Number	:	713-244-4565
Fax Number	:	713-777-5205

Authorized Official
Title or Position	:	CEO
Name	:	BONIFACE C IZEJI
Credential	:
Telephone Number	:	713-244-4565

Provider Enumeration Date	:	08/10/2009
Last Update Date	:	08/10/2009

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Directions to “WES HEALTHCARE INC. ” Practice Location

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