MEDICARE: DR. HERMAN JAMES MABRIE III 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	207Y00000X	Otolaryngology Physician	F4231	TX

General Provider Information

NPI Number	:	1447323563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERMAN JAMES MABRIE III M. D.

Provider Business Mailing Address
First Line	:	150 W PARKER RD
Second Line	:	SUITE 506
City	:	HOUSTON
State	:	TX
Zip	:	77076-2951
Country	:	US
Telephone Number	:	713-697-8382
Fax Number	:	713-697-9410

Provider Business Practice Location Address
First Line	:	150 W PARKER RD
Second Line	:	SUITE 506
City	:	HOUSTON
State	:	TX
Zip	:	77076-2951
Country	:	US
Telephone Number	:	713-697-8382
Fax Number	:	713-697-9410

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	05/12/2008

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