Provider Demographics
NPI:1740425115
Name:MED A CLINICO, INC.
Entity Type:Organization
Organization Name:MED A CLINICO, INC.
Other - Org Name:INTERNET MEDICAL CLINICS CYFAIR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-955-0000
Mailing Address - Street 1:12799 JONES ROAD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77380
Mailing Address - Country:US
Mailing Address - Phone:281-955-0000
Mailing Address - Fax:281-955-5305
Practice Address - Street 1:12799 JONES ROAD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-955-0000
Practice Address - Fax:281-955-5305
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMC CLINIC SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8751208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE8751OtherUPIN