MEDICARE: DR. LAURENT GRESSOT M.D.

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	174400000X	Specialist	H6257	TX
2	207RH0003X	Hematology & Oncology Physician	H6257	TX

General Provider Information

NPI Number	:	1215930367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURENT GRESSOT M.D.

Provider Business Mailing Address
First Line	:	17323 RED OAK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-1243
Country	:	US
Telephone Number	:	281-440-5006
Fax Number	:	281-440-6149

Provider Business Practice Location Address
First Line	:	17323 RED OAK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-1243
Country	:	US
Telephone Number	:	281-440-5006
Fax Number	:	281-440-6149

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	11/25/2014

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