MEDICARE: ELITE CARE MEDICAL 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	207Q00000X	Family Medicine Physician

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	:	1740298868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE CARE MEDICAL SERVICES INC

Provider Business Mailing Address
First Line	:	7447 HARWIN DR
Second Line	:	SUITE 109
City	:	HOUSTON
State	:	TX
Zip	:	77036-2016
Country	:	US
Telephone Number	:	832-251-6524
Fax Number	:	832-251-6529

Provider Business Practice Location Address
First Line	:	7447 HARWIN DR
Second Line	:	SUITE 109
City	:	HOUSTON
State	:	TX
Zip	:	77036-2016
Country	:	US
Telephone Number	:	832-251-6524
Fax Number	:	832-251-6529

Authorized Official
Title or Position	:	CLINIC ADMINISTRATOR
Name	:	MRS. VERONA K SPICER
Credential	:
Telephone Number	:	832-251-6524

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	10/14/2011

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Directions to “ELITE CARE MEDICAL SERVICES INC ” Practice Location

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