Provider Demographics
NPI:1386807659
Name:MEDCARE CLINC
Entity type:Organization
Organization Name:MEDCARE CLINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IFEOMA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ARENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-893-3656
Mailing Address - Street 1:12834 WILLOW CTR STE E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-3047
Mailing Address - Country:US
Mailing Address - Phone:281-893-3656
Mailing Address - Fax:281-896-3464
Practice Address - Street 1:12834 WILLOW CTR STE E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-3047
Practice Address - Country:US
Practice Address - Phone:281-893-3656
Practice Address - Fax:281-896-3464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL52292084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0063RHOtherBLUE CROSS GROUP
TX8BG010OtherBLUE CROSS NUMBER