MEDICARE: DOCTOR, MCCANN AND ARTHUR, LLP

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	291U00000X	Clinical Medical Laboratory	45D2091278	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45D2091278	OTHER	TX	CLIA

General Provider Information

NPI Number	:	1629581400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTOR, MCCANN AND ARTHUR, LLP

Provider Business Mailing Address
First Line	:	7505 MAIN ST STE 520
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4524
Country	:	US
Telephone Number	:	713-335-2354
Fax Number	:	713-790-1525

Provider Business Practice Location Address
First Line	:	7505 MAIN ST STE 520
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4524
Country	:	US
Telephone Number	:	713-335-2354
Fax Number	:	713-790-1525

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	WILLIAM STEWART
Credential	:
Telephone Number	:	713-335-2354

Provider Enumeration Date	:	11/15/2017
Last Update Date	:	11/15/2017

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