MEDICARE: SUGARCREEK CARE 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	261QH0100X	Health Service Clinic/Center		TX

General Provider Information

NPI Number	:	1821303686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUGARCREEK CARE SERVICES INC

Provider Business Mailing Address
First Line	:	13313 SOUTHWEST FWY
Second Line	:	SUITE 105
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3660
Country	:	US
Telephone Number	:	281-242-3270
Fax Number	:	281-240-0775

Provider Business Practice Location Address
First Line	:	13313 SOUTHWEST FWY
Second Line	:	SUITE 105
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3660
Country	:	US
Telephone Number	:	281-242-3270
Fax Number	:	281-240-0775

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. VICTOR EDET INYANG
Credential	:
Telephone Number	:	281-242-3270

Provider Enumeration Date	:	08/17/2010
Last Update Date	:	12/08/2010

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