MEDICARE: JUNE KNOWLTON LLC

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	207L00000X	Anesthesiology Physician
2	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1467062034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUNE KNOWLTON LLC

Provider Business Mailing Address
First Line	:	19506 LACE CACTUS DR
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-7758
Country	:	US
Telephone Number	:	281-785-7208
Fax Number	:

Provider Business Practice Location Address
First Line	:	1006 WINDSOR LAKES BLVD STE 150
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77384-4975
Country	:	US
Telephone Number	:	281-292-7246
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS S WHITE
Credential	:	M.D.
Telephone Number	:	281-785-7208

Provider Enumeration Date	:	08/07/2020
Last Update Date	:	02/23/2021

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Directions to “JUNE KNOWLTON LLC ” Practice Location

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