Healthcare Provider Details

I. General information

NPI: 1508031600
Provider Name (Legal Business Name): HELEN P MCCLOY PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HELEN P FOX MCCLOY

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 S MASON RD
KATY TX
77450-7633
US

IV. Provider business mailing address

3030 S MASON RD
KATY TX
77450-7633
US

V. Phone/Fax

Practice location:
  • Phone: 281-395-4300
  • Fax:
Mailing address:
  • Phone: 281-395-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number600119
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: