MR. CLINTON BROUSSARD (NPI# 1164816021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164816021 |
| Entity Type | Individual |
| Full Name | MR. CLINTON BROUSSARD |
| Practice Address |
4631 Knottynold Ln Houston TX 77053-1103 |
| Practice Telephone | 8324619852 |
| Practice Fax Number | 7134331753 |
| Mailing Telephone | 8324619852 |
| Mailing Fax Number | 7134331753 |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-03-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 343900000X | Non-emergency Medical Transport (VAN) | 10168489 | TX | Transportation Services |
| Street Address |
4631 KNOTTYNOLD LN |
| City | HOUSTON |
| State | TX |
| Zip Code | 77053-1103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831352442 | Evette Michelle Tryals-broussard | Registered Nurse | 4631 Knottynold Ln, Houston, TX 77053-1103 | 2008-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679065551 | The Genesis Project Usa | Private Vehicle | 16366 Paiter St, Houston, TX 77053 | 2018-06-05 |
| 1427549625 | Mary Joseph | Case Manager/Care Coordinator | 3830 Wimberley Hollow Ln, Houston, TX 77053 | 2018-05-23 |
| 1477076560 | Jermaine L Brown | Driver | 4631 Callery Creek Dr, Houston, TX 77053 | 2017-07-20 |
| 1164897948 | Almas Amin | Nurse Practitioner | 4411 Anderson Rd, Houston, TX 77053 | 2015-12-05 |
| 1740437201 | Senior Friends, Inc. | Case Manager/Care Coordinator | 8001 Mchard Rd., Suite 3, Houston, TX 77053 | 2008-08-26 |
| 1861697799 | Karing Hands Homes Hcs | Counselor | 4422 Knottynold, Houston, TX 77053 | 2007-06-20 |
| 1356372148 | Bosede O Adetunji | Licensed Practical Nurse | 15738 Boonridge Rd, Houston, TX 77053 | 2006-07-06 |
| 1679546642 | Joseph Ervin Hawkins | Counselor | 4319 Highpoint Lane, Houston, TX 77053 | 2006-02-09 |
| 1184015638 | Pauline Clement | Case Manager/Care Coordinator | 4731 Brownstone Ln, Houston, TX 77053-1203 | 2015-02-05 |
| 1174083059 | Raven Lewis-white | Counselor | 4726 Curly Oaks Dr, Houston, TX 77053-1210 | 2019-03-25 |
| Find all providers in zip 77053 | ||||
| Taxonomy Code | 343900000X |
| Grouping | Transportation Services |
| Classification | Non-emergency Medical Transport (VAN) |
| A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171946 | Cugo Group LLC | Non-emergency Medical Transport (VAN) | 2031 Westcreek Ln Apt 715, Houston, TX 77027-3033 | 2020-10-09 |
| 1417563768 | A.e.h. Auto Ltd. Co. | Non-emergency Medical Transport (VAN) | 7565 Bissonnet St, Houston, TX 77074-5501 | 2020-09-22 |
| 1477162337 | Jacory Aungi Proctor | Non-emergency Medical Transport (VAN) | 3545 Mainer St, Houston, TX 77021-5535 | 2020-07-27 |
| 1164030524 | Quick Safe Transportation | Non-emergency Medical Transport (VAN) | 1315 Mardi Ln, Houston, TX 77055-6426 | 2020-07-21 |
| 1538786983 | Sodiq Eyitayo Olaonipekun | Non-emergency Medical Transport (VAN) | 9850 S Kirkwood Rd Apt 1915, Houston, TX 77099-2582 | 2020-07-01 |
| 1518584291 | Momentum Plus Transport LLC | Non-emergency Medical Transport (VAN) | 4218 Almond Lake Dr, Houston, TX 77047-6772 | 2020-06-29 |
| 1487271128 | Medex Transportation Association | Non-emergency Medical Transport (VAN) | 4201 Cypress Creek Pkwy # 502, Houston, TX 77068-3414 | 2020-06-29 |
| 1063038495 | Olakunle Omiyale | Non-emergency Medical Transport (VAN) | 2620 Tanglewilde St Ste 103, Houston, TX 77063-3203 | 2020-06-22 |
| 1376168823 | Jessika D Myles | Non-emergency Medical Transport (VAN) | 15730 Wisteria Hill St, Houston, TX 77073-5692 | 2020-06-10 |
| 1013531151 | Olubukola O Oladokun Sr. | Non-emergency Medical Transport (VAN) | 4430 Garden Ridge Ct, Houston, TX 77084-7392 | 2020-06-04 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.