MEDICARE: MCCRAE MANAGEMENT AND INVESTMENTS, LTD.

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	332S00000X	Hearing Aid Equipment

General Provider Information

NPI Number	:	1619293933
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCCRAE MANAGEMENT AND INVESTMENTS, LTD.

Provider Business Mailing Address
First Line	:	26222 RR 12
Second Line	:
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-4903
Country	:	US
Telephone Number	:	512-858-0300
Fax Number	:	512-858-2714

Provider Business Practice Location Address
First Line	:	1144 W DALLAS ST
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77301-2208
Country	:	US
Telephone Number	:	936-756-4141
Fax Number	:	936-756-7241

Authorized Official
Title or Position	:	COO
Name	:	KIM JOHNSON
Credential	:
Telephone Number	:	512-858-0300

Provider Enumeration Date	:	04/12/2010
Last Update Date	:	12/28/2012

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