MEDICARE: CLEMENTS-MOORE 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	251E00000X	Home Health Agency	007872	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417992090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEMENTS-MOORE INC

Provider Business Mailing Address
First Line	:	9894 BISSONNET ST
Second Line	:	STE 365
City	:	HOUSTON
State	:	TX
Zip	:	77036-8239
Country	:	US
Telephone Number	:	713-777-9600
Fax Number	:	713-777-9664

Provider Business Practice Location Address
First Line	:	9894 BISSONNET ST
Second Line	:	STE 365
City	:	HOUSTON
State	:	TX
Zip	:	77036-8239
Country	:	US
Telephone Number	:	713-777-9600
Fax Number	:	713-777-9664

Authorized Official
Title or Position	:	CHEIF FANANCAL OFFICER
Name	:	MR. JIMMIE LEE MOORE
Credential	:
Telephone Number	:	713-777-9600

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	06/12/2008

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Directions to “CLEMENTS-MOORE INC ” Practice Location

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