Organization
PEDIATRIC SPECIALISTS OF CLEARLAKE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD EVANS (PRESIDENT)
(713) 852-1550
Entity
Organization
Contact information
Practice address
450 MEDICAL CENTER BLVD, STUIE 600, WEBSTER, TX 77598-4234
(281) 554-4300
(281) 554-4355
Mailing address
450 MEDICAL CENTER BLVD, STUIE 600, WEBSTER, TX 77598-4234
(281) 554-4300
(281) 554-4355
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196271401
—
TX
Enumeration date
06/17/2008
Last updated
04/01/2009
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