MEDICARE: DR. STEPHEN MATHEW CLOUTHIER DC

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	111N00000X	Chiropractor	7227	TX

General Provider Information

NPI Number	:	1821289786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN MATHEW CLOUTHIER DC

Provider Business Mailing Address
First Line	:	4840 W PANTHER CREEK DR
Second Line	:	SUITE 200
City	:	THE WOODLANDS
State	:	TX
Zip	:	77381
Country	:	US
Telephone Number	:	281-419-9104
Fax Number	:	281-419-8887

Provider Business Practice Location Address
First Line	:	2829 TECHNOLOGY FOREST BLVD STE 250
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77381-3913
Country	:	US
Telephone Number	:	281-419-9104
Fax Number	:	281-419-8887

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

Provider Enumeration Date	:	08/06/2007
Last Update Date	:	03/03/2020

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