| Clear Lake Brain And Spine | |
|
251 W Medical Center Blvd Ste 125 Webster TX 77598-4246 | |
| (832) 224-4204 | |
| Not Available |
| Full Name | Clear Lake Brain And Spine |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 251 W Medical Center Blvd Ste 125, Webster, Texas |
| Authorized Official Name and Position | Amro El Feki (PRESIDENT) |
| Authorized Official Contact | 5056156074 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Lake Brain And Spine Po Box 58809 Webster TX 77598-8809 Ph: (505) 615-6074 | Clear Lake Brain And Spine 251 W Medical Center Blvd Ste 125 Webster TX 77598-4246 Ph: (832) 224-4204 |
| NPI Number | 1962924589 |
|---|---|
| Provider Enumeration Date | 07/14/2017 |
| Last Update Date | 04/16/2020 |
| Certification Date | 04/16/2020 |
| Medicare PECOS PAC ID | 6901170802 |
|---|---|
| Medicare Enrollment ID | O20170915001067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962924589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | Q4577 (Texas) | Primary |
| Provider Name | Amro El Feki |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619016631 PECOS PAC ID: 9436329505 Enrollment ID: I20170915001585 |
| Provider Name | Kirsten Valerie Lew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295329662 PECOS PAC ID: 6305241274 Enrollment ID: I20210817000182 |
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