Provider Demographics
NPI:1083090500
Name:WATER TOWER MEDICAL CENTER LA CLINICA, INC
Entity Type:Organization
Organization Name:WATER TOWER MEDICAL CENTER LA CLINICA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NOOMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SILAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-385-9799
Mailing Address - Street 1:1115 E ARKANSAS LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-6415
Mailing Address - Country:US
Mailing Address - Phone:817-385-9799
Mailing Address - Fax:817-385-9881
Practice Address - Street 1:1115 E ARKANSAS LN
Practice Address - Street 2:SUITE B
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-6415
Practice Address - Country:US
Practice Address - Phone:817-385-9799
Practice Address - Fax:817-385-9881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center