MEDICARE: JEAN FREEDMAN

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	163WH0200X	Home Health Registered Nurse	931711	TX
2	163WC0400X	Case Management Registered Nurse	931711	TX

General Provider Information

NPI Number	:	1881173615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN FREEDMAN

Provider Business Mailing Address
First Line	:	3106 HARTCLIFF CIR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-6603
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 HIGHWAY 6 S
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-1035
Country	:	US
Telephone Number	:	713-575-2000
Fax Number	:

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

Provider Enumeration Date	:	08/13/2018
Last Update Date	:	08/13/2018

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