MEDICARE: MCTULU BILLING SERVICES, 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	251E00000X	Home Health Agency	801094099	TX

General Provider Information

NPI Number	:	1659640050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCTULU BILLING SERVICES, INC

Provider Business Mailing Address
First Line	:	5138 JEFFERSON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-3227
Country	:	US
Telephone Number	:	713-779-0558
Fax Number	:

Provider Business Practice Location Address
First Line	:	5138 JEFFERSON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-3227
Country	:	US
Telephone Number	:	713-779-0558
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MS. EZRA SEVERIN
Credential	:
Telephone Number	:	713-779-0558

Provider Enumeration Date	:	12/14/2011
Last Update Date	:	12/14/2011

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Directions to “MCTULU BILLING SERVICES, INC ” Practice Location

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