MEDICARE: KERRI SWIGGART P.A.

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	363AM0700X	Medical Physician Assistant	PA04469	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8N9916	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1568493344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRI SWIGGART P.A.

Provider Business Mailing Address
First Line	:	PO BOX 201088
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77216-1088
Country	:	US
Telephone Number	:	713-500-3500
Fax Number	:	713-500-5484

Provider Business Practice Location Address
First Line	:	1133 JOHN FREEMAN BLVD
Second Line	:	431
City	:	HOUSTON
State	:	TX
Zip	:	77030-2809
Country	:	US
Telephone Number	:	713-500-7878
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	07/08/2007

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Directions to “ KERRI SWIGGART P.A.” Practice Location

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