MEDICARE: CLARE N GENTRY 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	207R00000X	Internal Medicine Physician	L6392	TX
2	207RI0200X	Infectious Disease Physician	2006011984	MO
3	207RI0200X	Infectious Disease Physician	L6392	TX

General Provider Information

NPI Number	:	1881635209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARE N GENTRY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 58538
Second Line	:
City	:	WEBSTER
State	:	TX
Zip	:	77598-8538
Country	:	US
Telephone Number	:	346-739-8020
Fax Number	:

Provider Business Practice Location Address
First Line	:	4615 SOUTHWEST FWY STE 1000
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-7108
Country	:	US
Telephone Number	:	346-739-8020
Fax Number	:

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	12/11/2025

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