Provider Demographics
NPI:1467699306
Name:CLAYTON MEDICAL CARE CENTER, INC.
Entity Type:Organization
Organization Name:CLAYTON MEDICAL CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-513-2941
Mailing Address - Street 1:5715 WILL CLAYTON PKWY
Mailing Address - Street 2:SUITE 7056
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-8167
Mailing Address - Country:US
Mailing Address - Phone:325-513-2941
Mailing Address - Fax:
Practice Address - Street 1:5715 WILL CLAYTON PKWY
Practice Address - Street 2:SUITE 7056
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-8167
Practice Address - Country:US
Practice Address - Phone:325-513-2941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty