Provider Demographics
NPI:1275235905
Name:CLEAR AND COMPREHENSIVE DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:CLEAR AND COMPREHENSIVE DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-730-4527
Mailing Address - Street 1:PO BOX 3805
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77347-3805
Mailing Address - Country:US
Mailing Address - Phone:713-730-4527
Mailing Address - Fax:713-904-1633
Practice Address - Street 1:16630 IMPERIAL VALLEY DR STE 115
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3410
Practice Address - Country:US
Practice Address - Phone:713-730-4527
Practice Address - Fax:713-904-1633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service