Email received from : webuser@wellcare.com & ProspectiveProviderTX@wellcare.com  Sub : Re: Become A Provider - Unsecured - Internal Medicine - Texas  Provider First Name Segun  Provider Last Name Adeoye  Degree Type MD  Check to add provider to existing agreement: False  Check to join as a group: True  Check if you service more than one state: False  Group Name Nasa Health Clinic  Tax Identification Number 47-2682655  Specialty Internal Medicine  Line of Business All  Street Address 985 NASA Parkway  City Houston  State Texas  ZIP Code 77058  County Harris  Facility Walk in clinic  NPI 1629418025  CAQH Number 12779522  Medicare Number 746150  Medicaid Number 391190102  License Number R7637  Primary Contact Name Ahmed Talha  Email nasa@claimsmedinc.com  Phone Number (713) 893-6214  Please provide any additional information Secondary Location : 3623 S. Main St. Suite 109 Stafford , TX 77477-5406 Please list the secondary location too under same Tax I.D and NPI  Confirmation email of our application submission