Provider Demographics
NPI:1225764814
Name:ECR CLINIC PA
Entity Type:Organization
Organization Name:ECR CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:M
Authorized Official - Last Name:KREIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:346-550-1850
Mailing Address - Street 1:PO BOX 1816
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77328-1816
Mailing Address - Country:US
Mailing Address - Phone:346-550-1850
Mailing Address - Fax:
Practice Address - Street 1:24020 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1536
Practice Address - Country:US
Practice Address - Phone:346-550-1850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty