MEDICARE: MS. CATHY MECHELLE WILKINS

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

General Provider Information

NPI Number	:	1861699688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHY MECHELLE WILKINS

Provider Business Mailing Address
First Line	:	PO BOX 96053
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77213-6053
Country	:	US
Telephone Number	:	713-384-2274
Fax Number	:	281-454-7419

Provider Business Practice Location Address
First Line	:	14523 BRACKENHURST LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77049-1341
Country	:	US
Telephone Number	:	713-384-2274
Fax Number	:	281-454-7419

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

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	07/08/2007

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