MEDICARE: DR. CLINTON H DOERR 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	K2006	TX
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	K2006	TX
3	207RP1001X	Pulmonary Disease Physician	K2006	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00190026	OTHER	TX	RAILROAD MEDICARE #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7785430	OTHER	TX	AETNA PROV #
2	8R1144	OTHER	TX	BLUE CROSS PROV #
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790737187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLINTON H DOERR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 4346
Second Line	:	DEPT 794
City	:	HOUSTON
State	:	TX
Zip	:	77210-4346
Country	:	US
Telephone Number	:	713-255-4000
Fax Number	:	713-255-4050

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST STE 1632
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2734
Country	:	US
Telephone Number	:	713-255-4000
Fax Number	:	713-255-4050

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	10/26/2023

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Directions to “ DR. CLINTON H DOERR M.D.” Practice Location

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