Provider Demographics
NPI:1104684810
Name:APH CLINIC TX 1 LLC
Entity type:Organization
Organization Name:APH CLINIC TX 1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:R
Authorized Official - Last Name:REPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-633-4997
Mailing Address - Street 1:1616 CLEAR LAKE CITY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-8069
Mailing Address - Country:US
Mailing Address - Phone:713-493-1346
Mailing Address - Fax:848-213-0264
Practice Address - Street 1:1616 CLEAR LAKE CITY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-8069
Practice Address - Country:US
Practice Address - Phone:713-493-1346
Practice Address - Fax:848-213-0264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty