MEDICARE: NEUDORF INFECTIOUS DISEASES 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	207RI0200X	Infectious Disease Physician	P1789	TX

General Provider Information

NPI Number	:	1174887905
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUDORF INFECTIOUS DISEASES CLINIC

Provider Business Mailing Address
First Line	:	800 RIVERWOOD CT STE 102
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77304-2824
Country	:	US
Telephone Number	:	936-539-0090
Fax Number	:	936-788-2224

Provider Business Practice Location Address
First Line	:	800 RIVERWOOD CT STE 102
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77304-2824
Country	:	US
Telephone Number	:	936-539-0090
Fax Number	:	936-788-2224

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. SARAH ELIZABETH MILLER
Credential	:	MD
Telephone Number	:	936-539-0090

Provider Enumeration Date	:	06/26/2012
Last Update Date	:	04/03/2023

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