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1164816021
CLINTON BROUSSARD
HOUSTON, TX
NPI
1164816021
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
343900000X Non-emergency Medical Transport (VAN)
(Licence: TX 10168489)
Enumeration Date
2015-03-27
Last Update Date
2015-03-27
Business Address
Mr. CLINTON BROUSSARD
4631 KNOTTYNOLD LN
HOUSTON, TX 77053-1103
Phone number: 832-461-9852
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Mailing Address
Mr. CLINTON BROUSSARD
4631 KNOTTYNOLD LN
HOUSTON, TX 77053-1103
Phone number: 832-461-9852
Copy
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