MEDICARE: BIOSENTIENT CORPORATION

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
2	251F00000X	Home Infusion Agency

General Provider Information

NPI Number	:	1861791030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIOSENTIENT CORPORATION

Provider Business Mailing Address
First Line	:	4119 MONTROSE BLVD
Second Line	:	SUITE 230
City	:	HOUSTON
State	:	TX
Zip	:	77006-4963
Country	:	US
Telephone Number	:	713-528-9000
Fax Number	:	713-528-9003

Provider Business Practice Location Address
First Line	:	4119 MONTROSE BLVD
Second Line	:	SUITE 230
City	:	HOUSTON
State	:	TX
Zip	:	77006-4963
Country	:	US
Telephone Number	:	713-528-9000
Fax Number	:	713-528-9003

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MAE C JEMISON
Credential	:	M.D.
Telephone Number	:	713-528-9000

Provider Enumeration Date	:	03/27/2011
Last Update Date	:	03/27/2011

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