MEDICARE: JAMES M RORIE JR

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	1041C0700X	Clinical Social Worker	03920	TX
2	101YM0800X	Mental Health Counselor	16960	TX

General Provider Information

NPI Number	:	1982894515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES M RORIE JR

Provider Business Mailing Address
First Line	:	11211 KATY FWY SUITE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-2126
Country	:	US
Telephone Number	:	713-365-0700
Fax Number	:	713-827-1080

Provider Business Practice Location Address
First Line	:	11211 KATY FWY SUITE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-2126
Country	:	US
Telephone Number	:	713-365-0700
Fax Number	:	713-827-1080

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	JAMES M. RORIE V
Credential	:	LPC
Telephone Number	:	713-365-0700

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	08/04/2008

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