MEDICARE: PULMONARY CRITICAL CARE AND SLEEP MEDICINE CONSULTANTS, LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician
3	207RP1001X	Pulmonary Disease Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	DC6937	OTHER	TX	RAILROAD MEDICARE #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0019MA	OTHER	TX	BLUE CROSS GROUP#
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063464402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PULMONARY CRITICAL CARE AND SLEEP MEDICINE CONSULTANTS, LLP

Provider Business Mailing Address
First Line	:	DEPT 794
Second Line	:	PO BOX 4346
City	:	HOUSTON
State	:	TX
Zip	:	77210-4346
Country	:	US
Telephone Number	:	713-255-4000
Fax Number	:	713-255-4050

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST STE 1632
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2734
Country	:	US
Telephone Number	:	713-255-4066
Fax Number	:	713-255-4050

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DR. CLINTON HAROLD DOERR
Credential	:	MD
Telephone Number	:	713-255-4000

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	07/06/2022

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1790737187 — DR. CLINTON H DOERR M.D.
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1396798153 — DR. TIMOTHY ADRIAN CONNOLLY M.D.
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Directions to “PULMONARY CRITICAL CARE AND SLEEP MEDICINE CONSULTANTS, LLP ” Practice Location

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