Provider Demographics
NPI:1033805577
Name:CLEAR CHOICE LAREDO HOSPITAL PHYSICIANS GROUP
Entity Type:Organization
Organization Name:CLEAR CHOICE LAREDO HOSPITAL PHYSICIANS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:BUITRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-708-4913
Mailing Address - Street 1:6406 MCPHERSON RD STE 5
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6258
Mailing Address - Country:US
Mailing Address - Phone:956-625-2730
Mailing Address - Fax:
Practice Address - Street 1:6406 MCPHERSON RD STE 5
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6258
Practice Address - Country:US
Practice Address - Phone:956-625-2730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty