MEDICARE: C AND H FAMILY CLINIC LLC

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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1700162666
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C AND H FAMILY CLINIC LLC

Provider Business Mailing Address
First Line	:	6175 WILCREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-1449
Country	:	US
Telephone Number	:	281-498-6000
Fax Number	:	281-498-6004

Provider Business Practice Location Address
First Line	:	6175 WILCREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-1449
Country	:	US
Telephone Number	:	281-498-6000
Fax Number	:	281-498-6004

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	HAZEL BECKFORD
Credential	:	NP
Telephone Number	:	281-770-3173

Provider Enumeration Date	:	10/24/2011
Last Update Date	:	10/24/2011

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