MEDICARE: CLYDE MCMORRIS MD PA

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1558473025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLYDE MCMORRIS MD PA

Provider Business Mailing Address
First Line	:	PO BOX 325
Second Line	:
City	:	BROOKSHIRE
State	:	TX
Zip	:	77423-0325
Country	:	US
Telephone Number	:	713-655-0528
Fax Number	:	281-934-1020

Provider Business Practice Location Address
First Line	:	4019 FRONT ST
Second Line	:
City	:	BROOKSHIRE
State	:	TX
Zip	:	77423-2698
Country	:	US
Telephone Number	:	281-934-1000
Fax Number	:	281-934-1020

Authorized Official
Title or Position	:	DOCTOR
Name	:	CLYDE MCMORRIS JR.
Credential	:	MD
Telephone Number	:	713-655-0528

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/20/2024

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