Provider Demographics
NPI:1760721518
Name:ATWELL MEDICAL GROUP
Entity Type:Organization
Organization Name:ATWELL MEDICAL GROUP
Other - Org Name:ATAWELL MEDICAL LABORATORY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/FINANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:UCHE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCHENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-664-7800
Mailing Address - Street 1:6915 ATWELL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-6003
Mailing Address - Country:US
Mailing Address - Phone:713-664-7800
Mailing Address - Fax:
Practice Address - Street 1:6915 ATWELL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-6003
Practice Address - Country:US
Practice Address - Phone:713-664-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATWELL MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory