MEDICARE: GERALD GREENE

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1811421225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALD GREENE

Provider Business Mailing Address
First Line	:	13918 WESTHEIMER RD
Second Line	:	#465
City	:	HOUSTON
State	:	TX
Zip	:	77077-5359
Country	:	US
Telephone Number	:	832-855-1858
Fax Number	:

Provider Business Practice Location Address
First Line	:	13918 WESTHEIMER RD
Second Line	:	#465
City	:	HOUSTON
State	:	TX
Zip	:	77077-5359
Country	:	US
Telephone Number	:	832-855-1858
Fax Number	:

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

Provider Enumeration Date	:	04/12/2017
Last Update Date	:	04/12/2017

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Directions to “ GERALD GREENE ” Practice Location

Language	Start Address	Practice Location

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