MEDICARE: KAREN BROUSSARD

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	332B00000X	Durable Medical Equipment & Medical Supplies	0080639	TX

General Provider Information

NPI Number	:	1497703946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAREN BROUSSARD

Provider Business Mailing Address
First Line	:	10645 RICHMOND AVE
Second Line	:	SUITE 160
City	:	HOUSTON
State	:	TX
Zip	:	77042-4923
Country	:	US
Telephone Number	:	713-974-1176
Fax Number	:	713-783-2679

Provider Business Practice Location Address
First Line	:	10645 RICHMOND AVE
Second Line	:	SUITE 160
City	:	HOUSTON
State	:	TX
Zip	:	77042-4923
Country	:	US
Telephone Number	:	713-974-1176
Fax Number	:	713-783-2679

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DEANNA ESTES
Credential	:
Telephone Number	:	713-974-1176

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	03/14/2008

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