Provider Demographics
NPI:1528240462
Name:JUNO MEDICAL CLINIC
Entity type:Organization
Organization Name:JUNO MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAMIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MEMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-495-5866
Mailing Address - Street 1:9416 HIGHWAY 6 S
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-6306
Mailing Address - Country:US
Mailing Address - Phone:281-495-5866
Mailing Address - Fax:281-495-5868
Practice Address - Street 1:9416 HIGHWAY 6 S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-6306
Practice Address - Country:US
Practice Address - Phone:281-495-5866
Practice Address - Fax:281-495-5868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2439207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty