Provider Demographics
NPI:1598031064
Name:CLEARED FOR DUTY
Entity Type:Organization
Organization Name:CLEARED FOR DUTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:ESPINOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-718-2828
Mailing Address - Street 1:6826 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-2213
Mailing Address - Country:US
Mailing Address - Phone:956-718-2828
Mailing Address - Fax:956-718-2909
Practice Address - Street 1:6826 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-2213
Practice Address - Country:US
Practice Address - Phone:956-718-2828
Practice Address - Fax:956-718-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherWORKER'S COMPENSATION