Provider Demographics
NPI:1316394109
Name:HOUSTON MEDICAL WEIGHTLOSS CLINIC
Entity Type:Organization
Organization Name:HOUSTON MEDICAL WEIGHTLOSS CLINIC
Other - Org Name:HOUSTON MEDICAL WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD,MHSA
Authorized Official - Phone:713-781-1905
Mailing Address - Street 1:5910 FAIRDALE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-6307
Mailing Address - Country:US
Mailing Address - Phone:713-781-1905
Mailing Address - Fax:713-583-2992
Practice Address - Street 1:5910 FAIRDALE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-6307
Practice Address - Country:US
Practice Address - Phone:713-781-1905
Practice Address - Fax:713-583-2992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-21
Last Update Date:2016-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care