Provider Demographics
NPI:1073346862
Name:FOR THE GIRLS CLINIC PLLC
Entity type:Organization
Organization Name:FOR THE GIRLS CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TONITA
Authorized Official - Middle Name:BATES
Authorized Official - Last Name:LIVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:281-736-5079
Mailing Address - Street 1:2511 CREEKWAY CIR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2127
Mailing Address - Country:US
Mailing Address - Phone:281-736-5079
Mailing Address - Fax:
Practice Address - Street 1:3129 KINGSLEY DR STE 1320
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8510
Practice Address - Country:US
Practice Address - Phone:832-786-9786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty