Provider Demographics
NPI:1124255930
Name:CHILDREN'S CLINIC
Entity type:Organization
Organization Name:CHILDREN'S CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KOKAB
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-554-0123
Mailing Address - Street 1:1108 GULF FWY S
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-5100
Mailing Address - Country:US
Mailing Address - Phone:281-554-0123
Mailing Address - Fax:281-554-0124
Practice Address - Street 1:1108 GULF FWY S
Practice Address - Street 2:SUITE 210
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5100
Practice Address - Country:US
Practice Address - Phone:281-554-0123
Practice Address - Fax:281-554-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care