MEDICARE: MRS. DENNISE BATES

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1972549541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DENNISE BATES

Provider Business Mailing Address
First Line	:	3371 DIXIE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-1146
Country	:	US
Telephone Number	:	281-208-1705
Fax Number	:	281-499-7319

Provider Business Practice Location Address
First Line	:	3371 DIXIE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-1146
Country	:	US
Telephone Number	:	281-208-1705
Fax Number	:	281-499-7319

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

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	07/08/2007

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Directions to “ MRS. DENNISE BATES ” Practice Location

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