Provider Demographics
NPI:1063526051
Name:HARRIS CTY SHERIFFS DEPT CLINIC PHCY
Entity type:Organization
Organization Name:HARRIS CTY SHERIFFS DEPT CLINIC PHCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUN CHAING
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-755-6722
Mailing Address - Street 1:1200 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-1206
Mailing Address - Country:US
Mailing Address - Phone:713-755-6722
Mailing Address - Fax:713-755-1246
Practice Address - Street 1:1200 BAKER ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-1206
Practice Address - Country:US
Practice Address - Phone:713-755-6722
Practice Address - Fax:713-755-1246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
TX080723336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2099200OtherPK