Provider Demographics
NPI:1497306195
Name:CEARRA CLINICAL LLC
Entity Type:Organization
Organization Name:CEARRA CLINICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CEARRA
Authorized Official - Middle Name:TERESSAMARIE
Authorized Official - Last Name:PREJEAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:832-478-9721
Mailing Address - Street 1:11811 FM 1960 RD W STE 190
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3829
Mailing Address - Country:US
Mailing Address - Phone:832-478-9721
Mailing Address - Fax:
Practice Address - Street 1:11811 FM 1960 RD W STE 190
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3829
Practice Address - Country:US
Practice Address - Phone:832-478-9721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty