Organization
CCLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE HERRERA (AUTHORIZED REPRESENTATIVE)
(713) 973-7246
Entity
Organization
Contact information
Practice address
2646 S LOOP W, SUITE 665, HOUSTON, TX 77054-2665
(713) 973-7246
Mailing address
2646 S LOOP W, SUITE 665, HOUSTON, TX 77054-2665
(713) 973-7246
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
TX
208VP0000X
Pain Medicine Physician
Primary
—
TX
Other
Enumeration date
10/21/2014
Last updated
07/13/2015
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