Organization · NPI-2

Clinica De Su Comunidad LLC

Clinic/Center · Cypress, TX

NPI number1194152025
StatusActive
Last updated in NPPESOct 11, 2013

Details

NPI
1194152025
Entity type
Organization (NPI-2)
Legal business name
Clinica De Su Comunidad LLC
Organization subpart
No
Enumeration date
Oct 9, 2013
Last updated
Oct 11, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center–TXYes

Practice location

15334 Misty Dawn Trl
Cypress, TX 77433-5893

Phone 508-667-8601

Mailing address

15334 Misty Dawn Trl
Cypress, TX 77433-5893

Phone 508-667-8601

Authorized official

Olugbenga Coker
Owner
5086678601

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