| Clear Lake Integrative Medicine | |
|
1335 Regents Park Dr Ste 110 Houston TX 77058-2541 | |
| (713) 425-2524 | |
| (281) 783-2318 |
| Full Name | Clear Lake Integrative Medicine |
|---|---|
| Speciality | General Practice |
| Location | 1335 Regents Park Dr Ste 110, Houston, Texas |
| Authorized Official Name and Position | Rachael Hendrikz (OPERATIONS MANAGER) |
| Authorized Official Contact | 7134252524 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Lake Integrative Medicine 1335 Regents Park Dr Ste 110 Houston TX 77058-2541 Ph: (713) 425-2524 | Clear Lake Integrative Medicine 1335 Regents Park Dr Ste 110 Houston TX 77058-2541 Ph: (713) 425-2524 |
| NPI Number | 1972134229 |
|---|---|
| Provider Enumeration Date | 01/27/2020 |
| Last Update Date | 01/27/2020 |
| Medicare PECOS PAC ID | 2961832464 |
|---|---|
| Medicare Enrollment ID | O20200424000432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972134229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Crystal Fewox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326406695 PECOS PAC ID: 0446559108 Enrollment ID: I20160502000217 |
| Provider Name | Mechelle Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942672241 PECOS PAC ID: 0244515625 Enrollment ID: I20170327002417 |
| Provider Name | Stefani Hobbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528522786 PECOS PAC ID: 5698002863 Enrollment ID: I20190809002638 |
| Provider Name | Earl Franklin Hendrikz |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1144520735 PECOS PAC ID: 1951731454 Enrollment ID: I20200424000721 |
| Provider Name | Cloe Elizabeth Ann Kinnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912517657 PECOS PAC ID: 6103243068 Enrollment ID: I20200825000009 |
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