MEDICARE: CNS MEDICAL GROUP

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	174400000X	Specialist

General Provider Information

NPI Number	:	1093242166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CNS MEDICAL GROUP

Provider Business Mailing Address
First Line	:	PO BOX 111582
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77293-0582
Country	:	US
Telephone Number	:	832-654-7859
Fax Number	:

Provider Business Practice Location Address
First Line	:	6238 RIETTA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77016-4338
Country	:	US
Telephone Number	:	832-654-7859
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	NICOLE MCNEAL
Credential	:
Telephone Number	:	832-654-7859

Provider Enumeration Date	:	05/18/2017
Last Update Date	:	05/18/2017

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Directions to “CNS MEDICAL GROUP ” Practice Location

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