MEDICARE: BOBBY GEORGE

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	363A00000X	Physician Assistant	PA11211	TX

General Provider Information

NPI Number	:	1295267144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOBBY GEORGE

Provider Business Mailing Address
First Line	:	16537 SOUTHWEST FWY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16537 SOUTHWEST FWY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7238
Country	:	US
Telephone Number	:	346-874-2525
Fax Number	:

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

Provider Enumeration Date	:	03/30/2017
Last Update Date	:	06/17/2024

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Directions to “ BOBBY GEORGE ” Practice Location

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