Provider Demographics
NPI:1992444889
Name:CLINICA LATINA FAMILIAR 3 LLC
Entity type:Organization
Organization Name:CLINICA LATINA FAMILIAR 3 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YAIKER
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ DOPICO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-239-7262
Mailing Address - Street 1:3300 B F TERRY BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-6360
Mailing Address - Country:US
Mailing Address - Phone:281-239-7262
Mailing Address - Fax:281-239-7256
Practice Address - Street 1:3300 B F TERRY BLVD STE C
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-6360
Practice Address - Country:US
Practice Address - Phone:281-239-7262
Practice Address - Fax:281-239-7256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2024-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty