Provider Demographics
NPI:1790826196
Name:ATWELL MEDICAL CENTER INC
Entity Type:Organization
Organization Name:ATWELL MEDICAL CENTER INC
Other - Org Name:ATWELL MEDICAL CENTER, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
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:713-981-5777
Mailing Address - Street 1:6915 ATWELL DRIVE
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:713-981-5777
Mailing Address - Fax:713-981-8501
Practice Address - Street 1:6915 ATWELL DRIVE
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:713-981-5777
Practice Address - Fax:713-981-8501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0925257Medicaid
TX0925257Medicaid