Organization
SURGICAL SPECIALISTS OF CLEAR LAKE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS WADLINGTON (GROUP VICE PRESIDENT)
(615) 372-7332
Entity
Organization
Contact information
Practice address
200 MEDICAL CENTER BLVD, STE 101, WEBSTER, TX 77598-4226
(281) 332-4596
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 373-7406
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193267501
—
TX
01
—
DH1753
RAILROAD MEDICARE
TX
Enumeration date
01/02/2008
Last updated
11/21/2025
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