Provider Demographics
NPI:1184015638
Name:CLEMENT, PAULINE
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4731 BROWNSTONE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77053-1203
Mailing Address - Country:US
Mailing Address - Phone:832-731-6712
Mailing Address - Fax:832-218-2373
Practice Address - Street 1:4731 BROWNSTONE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77053-1203
Practice Address - Country:US
Practice Address - Phone:832-731-6712
Practice Address - Fax:832-218-2373
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator