MEDICARE: HOMESTEAD MEDICAL CLINIC

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	174V00000X	Clinical Ethicist	H0743	TX

General Provider Information

NPI Number	:	1033422464
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMESTEAD MEDICAL CLINIC

Provider Business Mailing Address
First Line	:	8213 HOMESTEAD RD
Second Line	:	#A
City	:	HOUSTON
State	:	TX
Zip	:	77028-2152
Country	:	US
Telephone Number	:	281-974-1147
Fax Number	:	832-767-5108

Provider Business Practice Location Address
First Line	:	8213 HOMESTEAD RD
Second Line	:	#A
City	:	HOUSTON
State	:	TX
Zip	:	77028-2152
Country	:	US
Telephone Number	:	281-974-1147
Fax Number	:	832-767-5108

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	JOHN RAMIREZ
Credential	:	M.D.
Telephone Number	:	713-614-8747

Provider Enumeration Date	:	07/14/2010
Last Update Date	:	04/13/2011

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