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Organization
CLEAR LAKE SPINE CENTER, LLC
Active
Organization
CLEAR LAKE SPINE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY C WANG M.D. (SPINE)
(713) 807-7721
Entity
Organization
Contact information
Practice address
3750 MEDICAL PARK DR, SUITE 300, DICKINSON, TX 77539
(713) 357-4400
Mailing address
2616 MASON ST, HOUSTON, TX 77006-3116
(713) 807-7721
(281) 333-1303
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
008379
TX
Other
Enumeration date
10/30/2008
Last updated
10/30/2008
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