Organization
LIFEPOST MEDICAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL U UBOKUDOM (ADMINISTRATOR)
(832) 202-3244
Entity
Organization
Contact information
Practice address
9207 COUNTRY CREEK DR, SUITE 111, HOUSTON, TX 77036-7745
(832) 202-3244
Mailing address
9207 COUNTRY CREEK DR, SUITE 111, HOUSTON, TX 77036-7745
(832) 202-3244
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
L7754
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L7754
TEXAS
TX
Enumeration date
03/20/2012
Last updated
06/01/2012
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