Provider Demographics
NPI:1467010660
Name:PREMIER CLINIC PLLC
Entity Type:Organization
Organization Name:PREMIER CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IMRAN
Authorized Official - Middle Name:RAHEEM
Authorized Official - Last Name:POONAWALA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-213-2761
Mailing Address - Street 1:13311 HARGRAVE RD STE 120B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4313
Mailing Address - Country:US
Mailing Address - Phone:713-213-2761
Mailing Address - Fax:281-890-6865
Practice Address - Street 1:13311 HARGRAVE RD STE 120B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4313
Practice Address - Country:US
Practice Address - Phone:713-213-2761
Practice Address - Fax:281-890-6865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty