MEDICARE: THOMAS J CLEGG MD

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	207Y00000X	Otolaryngology Physician	F3842	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730162231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS J CLEGG MD

Provider Business Mailing Address
First Line	:	14140 SOUTHWEST FWY STE 200
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3842
Country	:	US
Telephone Number	:	281-649-7000
Fax Number	:	713-484-6649

Provider Business Practice Location Address
First Line	:	22999 HIGHWAY 59 N
Second Line	:	BLDG B, SUITE 400
City	:	KINGWOOD
State	:	TX
Zip	:	77339-4412
Country	:	US
Telephone Number	:	281-358-2314
Fax Number	:	281-358-2357

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

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	10/21/2019

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Directions to “ THOMAS J CLEGG MD” Practice Location

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