MEDICARE: NSM CLINIC

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1710394200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NSM CLINIC

Provider Business Mailing Address
First Line	:	8900 KIRBY DR
Second Line	:	SUITE 260-265
City	:	HOUSTON
State	:	TX
Zip	:	77054-2831
Country	:	US
Telephone Number	:	832-639-4102
Fax Number	:	713-261-1592

Provider Business Practice Location Address
First Line	:	8900 KIRBY DR
Second Line	:	SUITE 260-265
City	:	HOUSTON
State	:	TX
Zip	:	77054-2831
Country	:	US
Telephone Number	:	713-681-3599
Fax Number	:	713-681-3594

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DARTANTIN CORTEZ BAILEY
Credential	:
Telephone Number	:	832-639-4102

Provider Enumeration Date	:	07/16/2014
Last Update Date	:	11/02/2016

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Directions to “NSM CLINIC ” Practice Location

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