MEDICARE: MS. PEARLIE RILEY WARD LBSW

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	104100000X	Social Worker	04231	TX

General Provider Information

NPI Number	:	1851670392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PEARLIE RILEY WARD LBSW

Provider Business Mailing Address
First Line	:	12623 MANSFIELD GLEN CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1970
Country	:	US
Telephone Number	:	832-731-8251
Fax Number	:	832-249-1106

Provider Business Practice Location Address
First Line	:	12623 MANSFIELD GLEN CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1970
Country	:	US
Telephone Number	:	832-731-8251
Fax Number	:	832-249-1106

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

Provider Enumeration Date	:	08/16/2011
Last Update Date	:	08/16/2011

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