Provider Demographics
NPI:1407992191
Name:HARRIS COUNTY PUBLIC HEALTH & ENVIRONMENTAL SERVICES - BAYTOWN CLINIC
Entity Type:Organization
Organization Name:HARRIS COUNTY PUBLIC HEALTH & ENVIRONMENTAL SERVICES - BAYTOWN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:UMAIR
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:713-439-6184
Mailing Address - Street 1:1000 LEE DR
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-6980
Mailing Address - Country:US
Mailing Address - Phone:281-427-5195
Mailing Address - Fax:
Practice Address - Street 1:1000 LEE DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-6980
Practice Address - Country:US
Practice Address - Phone:281-427-5195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017629901Medicaid
TX029225201Medicaid
TX065191101Medicaid
TX018974801Medicaid