MEDICARE: MR. GEORGE BEMENT LCSW

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	1041C0700X	Clinical Social Worker	35225	TX

General Provider Information

NPI Number	:	1114206661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GEORGE BEMENT LCSW

Provider Business Mailing Address
First Line	:	PO BOX 66690
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77266-6690
Country	:	US
Telephone Number	:	713-220-9731
Fax Number	:	713-220-9743

Provider Business Practice Location Address
First Line	:	1212 PRAIRIE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-2008
Country	:	US
Telephone Number	:	713-220-9731
Fax Number	:

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

Provider Enumeration Date	:	08/15/2011
Last Update Date	:	08/15/2011

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