Provider Demographics
NPI:1477987964
Name:MEDWISE LLC
Entity Type:Organization
Organization Name:MEDWISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:B
Authorized Official - Last Name:LEBLANC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-934-4500
Mailing Address - Street 1:350 N SAM HOUSTON PKWY E
Mailing Address - Street 2:STE 271
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3333
Mailing Address - Country:US
Mailing Address - Phone:713-934-4500
Mailing Address - Fax:800-215-4840
Practice Address - Street 1:350 N SAM HOUSTON PKWY E
Practice Address - Street 2:STE 271
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3333
Practice Address - Country:US
Practice Address - Phone:713-934-4500
Practice Address - Fax:800-215-4840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0046761332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies