1174385918 NPI number — CARE4U CLINIC PLLC

Table of content: (NPI 1174385918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174385918 NPI number — CARE4U CLINIC PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE4U CLINIC PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174385918
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11606 WESTMOOR DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77407-2990
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-249-0440
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6410 HWY 90 ALT
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77498
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-468-0880
Provider Business Practice Location Address Fax Number:
713-234-4018
Provider Enumeration Date:
01/26/2024

Additional Information

Authorized Official

Authorized Official Last Name:
CEBALLOS
Authorized Official First Name:
GILDARDO
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PHYSICIAN/OWNER
Authorized Official Telephone Number:
713-299-7749

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com