MEDICARE: HPS HOUSTON, 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	174400000X	Specialist

General Provider Information

NPI Number	:	1548701519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HPS HOUSTON, LLC

Provider Business Mailing Address
First Line	:	4108 PARK ROAD
Second Line	:	SUITE 205
City	:	CHARLOTTE
State	:	NC
Zip	:	28209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4219 RICHMOND AVE STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-6838
Country	:	US
Telephone Number	:	877-884-4438
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOHN LINN
Credential	:
Telephone Number	:	704-248-7562

Provider Enumeration Date	:	03/10/2017
Last Update Date	:	03/10/2017

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Directions to “HPS HOUSTON, LLC ” Practice Location

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