Provider Demographics
NPI:1417959784
Name:MEDICAL CLINIC OF BELLAIRE PA
Entity Type:Organization
Organization Name:MEDICAL CLINIC OF BELLAIRE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-526-5606
Mailing Address - Street 1:5959 WEST LOOP S STE 510
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2406
Mailing Address - Country:US
Mailing Address - Phone:713-526-5606
Mailing Address - Fax:713-526-0058
Practice Address - Street 1:5959 WEST LOOP S STE 510
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:713-526-5606
Practice Address - Fax:713-526-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5547174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0017LMOtherBLUE CROSS GROUP #
TX1740399484OtherINDIVIDUAL NPI
TXH27858Medicare UPIN