Provider Demographics
NPI:1346692894
Name:CLEARVUE CENTER, LLC
Entity Type:Organization
Organization Name:CLEARVUE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:VANHORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-265-1071
Mailing Address - Street 1:4090 MAPLESHADE LANE
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075
Mailing Address - Country:US
Mailing Address - Phone:972-265-1071
Mailing Address - Fax:214-313-9113
Practice Address - Street 1:4090 MAPLESHADE LANE
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075
Practice Address - Country:US
Practice Address - Phone:972-265-1071
Practice Address - Fax:214-313-9113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEIN