Provider Demographics
NPI:1417992090
Name:CLEMENTS-MOORE INC
Entity Type:Organization
Organization Name:CLEMENTS-MOORE INC
Other - Org Name:METRO HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHEIF FANANCAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-777-9600
Mailing Address - Street 1:9894 BISSONNET ST
Mailing Address - Street 2:STE 365
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8239
Mailing Address - Country:US
Mailing Address - Phone:713-777-9600
Mailing Address - Fax:713-777-9664
Practice Address - Street 1:9894 BISSONNET ST
Practice Address - Street 2:STE 365
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8239
Practice Address - Country:US
Practice Address - Phone:713-777-9600
Practice Address - Fax:713-777-9664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007872251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001013592Medicaid
TX156353802Medicaid
TX001013734Medicaid
TX156353801Medicaid
TX001012208Medicaid
TX156353801Medicaid
TX677901Medicare ID - Type UnspecifiedHOME HEALTH