Provider Demographics
NPI:1316541808
Name:LENNOX CLINICAL SERVICES LLC
Entity Type:Organization
Organization Name:LENNOX CLINICAL SERVICES LLC
Other - Org Name:AGAPE RAPID CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DE ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-973-4731
Mailing Address - Street 1:8702 THISTLEMOOR LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-6548
Mailing Address - Country:US
Mailing Address - Phone:281-973-4731
Mailing Address - Fax:281-764-6960
Practice Address - Street 1:6565 WEST LOOP S STE 110B
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3505
Practice Address - Country:US
Practice Address - Phone:281-973-4731
Practice Address - Fax:281-764-6960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty