Organization
CCLINIC ALLIANCE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGGIE ABRAHAM (VP OF BUSINESS OPERATIONS)
(713) 730-4766
Entity
Organization
Contact information
Practice address
8111 SOUTHWEST FWY, HOUSTON, TX 77074-1705
(713) 730-4800
Mailing address
8111 SOUTHWEST FREEWAY, HOUSTON, TX 77074-1705
(713) 730-4800
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
11/20/2014
Last updated
07/21/2022
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