Organization
EAST END MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHANDRALATHA THOTA MD (OFFICER)
(713) 921-6627
Entity
Organization
Contact information
Practice address
906 WAYSIDE DR, HOUSTON, TX 77011-2518
(713) 923-6627
(713) 923-9383
Mailing address
906 WAYSIDE DR, HOUSTON, TX 77011-2518
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135167807
—
TX
05
—
1386735348
—
TX
Enumeration date
09/27/2006
Last updated
10/02/2014
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