Provider Demographics
NPI:1316074438
Name:THE PEARLAND CLINIC P.A.
Entity type:Organization
Organization Name:THE PEARLAND CLINIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRANCHANDRA
Authorized Official - Middle Name:MAGANLAL
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-436-9800
Mailing Address - Street 1:15419 ROCKY OAK CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3128
Mailing Address - Country:US
Mailing Address - Phone:713-436-9800
Mailing Address - Fax:713-436-5551
Practice Address - Street 1:15419 ROCKY OAK CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77059-3128
Practice Address - Country:US
Practice Address - Phone:713-436-9800
Practice Address - Fax:713-436-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00309UMedicare ID - Type Unspecified