MEDICARE: THE ORDER OF LOVE PEACE TRUTH TOLERANCE AND COOPERATION

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1922331263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ORDER OF LOVE PEACE TRUTH TOLERANCE AND COOPERATION

Provider Business Mailing Address
First Line	:	PO BOX 62230
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77205-2230
Country	:	US
Telephone Number	:	832-202-9922
Fax Number	:	866-234-8707

Provider Business Practice Location Address
First Line	:	6009 RICHMOND AVE
Second Line	:	SUITE 115
City	:	HOUSTON
State	:	TX
Zip	:	77057-6226
Country	:	US
Telephone Number	:	713-974-2483
Fax Number	:	866-234-8707

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	MR. JASON TAYLOR HUGHES
Credential	:
Telephone Number	:	713-295-0033

Provider Enumeration Date	:	09/17/2009
Last Update Date	:	09/17/2009

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Directions to “THE ORDER OF LOVE PEACE TRUTH TOLERANCE AND COOPERATION ” Practice Location

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