Provider Demographics
NPI:1467726281
Name:CLEAR DERMATOLOGY PLLC
Entity Type:Organization
Organization Name:CLEAR DERMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LIBBYETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-984-0010
Mailing Address - Street 1:17756 KATY FREEWAY #G1
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094
Mailing Address - Country:US
Mailing Address - Phone:832-772-3330
Mailing Address - Fax:832-772-3332
Practice Address - Street 1:17756 KATY FWY STE G1
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1380
Practice Address - Country:US
Practice Address - Phone:832-772-3330
Practice Address - Fax:832-772-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty