PEDIATRIC SPECIALISTS OF CLEARLAKE PLLC (NPI# 1770743304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770743304 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SPECIALISTS OF CLEARLAKE PLLC |
| Practice Address |
450 Medical Center Blvd Stuie 600 Webster TX 77598-4234 |
| Practice Telephone | 2815544300 |
| Practice Fax Number | 2815544355 |
| Mailing Telephone | 2815544300 |
| Mailing Fax Number | 2815544355 |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2009-04-01 |
| Authorized Official Name | TODD EVANS (PRESIDENT) |
| Authorized Official Telephone | 7138521550 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 196271401 | 05 |
| Street Address |
450 MEDICAL CENTER BLVD STUIE 600 |
| City | WEBSTER |
| State | TX |
| Zip Code | 77598-4234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376543553 | James Allen Blackburn | Physician Assistant | 450 Medical Center Blvd, Suite 201, Webster, TX 77598 | 2005-07-28 |
| 1619277183 | Neuro-hospitalist of Clear Lake, Pllc | Psychiatry & Neurology | 450 Medical Center Blvd, Suite 600, Webster, TX 77598-4234 | 2010-10-29 |
| 1831372366 | R Patrick Rudy Md Pa | Internal Medicine | 450 Medical Center Blvd, # 300, Webster, TX 77598-4233 | 2007-12-06 |
| 1891811667 | Prapand Apisarnthanarax | Dermatology | 450 Medical Center Blvd, Suite 309, Webster, TX 77598-4234 | 2007-03-22 |
| 1518096379 | Mohamed Shalaby, Md, Pa | Internal Medicine | 450 Medical Center Blvd, 510, Webster, TX 77598-4234 | 2007-03-05 |
| 1578570867 | Junaid Ahmad Khan | Internal Medicine | 450 Medical Center Blvd, Suite 203, Webster, TX 77598-4234 | 2006-08-01 |
| 1700892148 | Stephen G. Kimmel | Surgery | 450 Medical Center Blvd, Suite 600c, Webster, TX 77598 | 2006-07-31 |
| 1417982356 | Freda J Bowman | Obstetrics & Gynecology | 450 Medical Center Blvd, 310, Webster, TX 77598-4234 | 2006-07-11 |
| 1114956869 | Clear Lake Cardiovascular Care Pa | Internal Medicine | 450 Medical Center Blvd, Suite 308, Webster, TX 77598-4234 | 2006-07-02 |
| 1275562308 | Clear Lake Cardiology Associates | Specialist | 450 Medical Center Blvd, Suite 550, Webster, TX 77598-4234 | 2006-07-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816376 | Philippe Joseph Dentino | Physical Therapist | 14520 Tx-3, Webster, TX 77598 | 2020-09-21 |
| 1093324428 | Complete Care Obgyn and Family Medicine Pllc | Obstetrics & Gynecology | 1408 W Nasa Parkway, Ste A, Webster, TX 77598 | 2020-07-31 |
| 1366082562 | Ryse Chiropractic Plus Spa LLC | Chiropractor | 780 Clear Lake City Blvd., Bldg. 1-a, Webster, TX 77598 | 2020-01-15 |
| 1770133837 | Wellness Vip, LLC | Occupational Therapist | 1011 W.bay Area Blvd Ste. 1102, Webster, TX 77598 | 2019-09-19 |
| 1689236341 | Houston Advanced Surgical Services, LLC | Physician Assistant | 500 W. Medical Center Blvd., Webster, TX 77598 | 2019-07-02 |
| 1528524295 | Luxury Dialycare Pllc | Clinic/Center | 600 N. Kobayashi Road, Suite 108, Webster, TX 77598 | 2019-02-18 |
| 1124501879 | Vip Vision LLC | Optometrist | 1310 Jasmine St., Webster, TX 77598 | 2018-09-10 |
| 1073094322 | Asha Mathew | Family Medicine | Brain and Spine Clinic Pa, Suite 250, 400 W Medical Center Blvd, Webster, TX 77598 | 2018-08-24 |
| 1760960991 | Bryce Ethan Jeffrey | Physical Therapist | 1416 Fm 528 Ste A, Webster, TX 77598 | 2018-07-31 |
| 1841777281 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1310 Jasmine Avenue, Webster, TX 77598 | 2018-07-27 |
| Find all providers in zip 77598 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922491448 | Pediatric Cardiology Care Pa | Pediatrics | 711 W Bay Area Blvd, Suite 625, Webster, TX 77598-4043 | 2015-03-09 |
| 1992959142 | Tal Alon Gospin | Pediatrics | 711 W Bay Area Blvd, Suite 625, Webster, TX 77598-4043 | 2008-11-13 |
| 1689611378 | Jose A. Quinones | Pediatrics | 450 Medical Center Blvd, Ste 600, Webster, TX 77598-4234 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114544640 | Adebo Clinic, Pllc | Pediatrics | 16651 Southwest Fwy Ste 150, Sugar Land, TX 77479-2346 | 2020-06-30 |
| 1487285656 | Total Care Pllc | Pediatrics | 7888 Gateway Blvd E Fl 2nd, El Paso, TX 79915-1815 | 2020-01-28 |
| 1891127726 | Stephanie Ghaleb | Pediatrics | 3333 S.alameda St, 13k, Corpus Christi, TX 78411 | 2013-08-02 |
| 1417202177 | Unnati Doshi | Pediatrics | 17510 W Grand Pkwy S Ste 550, Sugar Land, TX 77479-2649 | 2012-07-18 |
| 1780948737 | Tam Dan Nguyen Pham | Pediatrics | 6651 Main St Fl 19, Houston, TX 77030-2351 | 2012-06-25 |
| 1710245642 | Jerry Thyparampil Michael | Pediatrics | 3533 S Alameda St Ste H-100, Corpus Christi, TX 78411-1721 | 2012-04-29 |
| 1578883187 | Fetal Care Consultants, LLC. | Pediatrics | 7777 Forest Ln Ste 742, Dallas, TX 75230-2571 | 2010-06-04 |
| 1134446073 | Kristal L Woldu | Pediatrics | 1500 Cooper St Fl 3, Fort Worth, TX 76104-2710 | 2010-05-03 |
| 1063738961 | Roberto L. Villarreal Mdpa | Pediatrics | 6553 Metro Court, Suite A, Laredo, TX 78041 | 2010-04-16 |
| 1982840815 | Valley Pediatric Cardiology, P.l.l.c | Pediatrics | 702 E. Expressway 83 Suite A3, Donna, TX 78537 | 2008-12-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.