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Individual

MR. CLINTON BROUSSARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4631 KNOTTYNOLD LN, HOUSTON, TX 77053-1103
(832) 461-9852
(713) 433-1753
Mailing address
4631 KNOTTYNOLD LN, HOUSTON, TX 77053-1103
(832) 461-9852
(713) 433-1753

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
10168489
TX

Other

Enumeration date
03/27/2015
Last updated
03/27/2015
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