MEDICARE: CLEAR CREEK HEALTHCARE, INC.

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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1023579273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR CREEK HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	17040 EL CAMINO REAL STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-2601
Country	:	US
Telephone Number	:	832-588-6083
Fax Number	:

Provider Business Practice Location Address
First Line	:	17040 EL CAMINO REAL STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-2601
Country	:	US
Telephone Number	:	832-588-6083
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	AMBER L TUELLER
Credential	:
Telephone Number	:	208-207-2726

Provider Enumeration Date	:	03/29/2019
Last Update Date	:	06/11/2025

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