Provider Demographics
NPI:1104023993
Name:NICOLAU CLEGHORN, YAMILETH DEL CARMEN (MD)
Entity Type:Individual
Prefix:DR
First Name:YAMILETH
Middle Name:DEL CARMEN
Last Name:NICOLAU CLEGHORN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10740 N GESSNER DR
Mailing Address - Street 2:STE 310
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1240
Mailing Address - Country:US
Mailing Address - Phone:281-897-0416
Mailing Address - Fax:281-890-8908
Practice Address - Street 1:18648 MCKAY DR
Practice Address - Street 2:STE 120
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:281-548-2626
Practice Address - Fax:281-548-1659
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2021-08-09
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Provider Licenses
StateLicense IDTaxonomies
TXP2745207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3107013-01Medicaid
TXTXB162889Medicare PIN