Provider Demographics
NPI:1609393388
Name:NEW ERA CLINIC PLLC
Entity Type:Organization
Organization Name:NEW ERA CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:OBIORA
Authorized Official - Last Name:OKOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-498-3245
Mailing Address - Street 1:1716 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3604
Mailing Address - Country:US
Mailing Address - Phone:832-498-3245
Mailing Address - Fax:
Practice Address - Street 1:1716 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3604
Practice Address - Country:US
Practice Address - Phone:832-498-3245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5521207R00000X
208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty