Provider Demographics
NPI:1306284989
Name:CLAREWOOD HEALTH CENTER LLC
Entity type:Organization
Organization Name:CLAREWOOD HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YERZHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DVUKENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-988-8787
Mailing Address - Street 1:6633 HILLCROFT ST
Mailing Address - Street 2:STE 112
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-4887
Mailing Address - Country:US
Mailing Address - Phone:713-988-8787
Mailing Address - Fax:713-988-8897
Practice Address - Street 1:6633 HILLCROFT ST
Practice Address - Street 2:STE 112
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4887
Practice Address - Country:US
Practice Address - Phone:713-988-8787
Practice Address - Fax:713-988-8897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty