MEDICARE: NICOLA BRUNETTI-PIERRI MD

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	207SG0201X	Clinical Genetics (M.D.) Physician	N1567	TX
2	208000000X	Pediatrics Physician	N1567	TX

General Provider Information

NPI Number	:	1568609576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLA BRUNETTI-PIERRI MD

Provider Business Mailing Address
First Line	:	6701 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2316
Country	:	US
Telephone Number	:	832-822-4280
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 GREENWAY PLZ
Second Line	:	SUITE 900
City	:	HOUSTON
State	:	TX
Zip	:	77046-0297
Country	:	US
Telephone Number	:	713-798-1750
Fax Number	:	713-798-1144

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2009
Last Update Date	:	01/13/2009

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