MEDICARE: EARL J CLEMENT II M.D.

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	M1056	TX

General Provider Information

NPI Number	:	1649300351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EARL J CLEMENT II M.D.

Provider Business Mailing Address
First Line	:	8011 GLENFOREST CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77061-1142
Country	:	US
Telephone Number	:	713-446-2229
Fax Number	:	713-649-2906

Provider Business Practice Location Address
First Line	:	8011 GLENFOREST CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77061-1142
Country	:	US
Telephone Number	:	713-446-2229
Fax Number	:	713-649-2906

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	10/14/2009

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