Provider Demographics
NPI:1740429109
Name:HOLY MEDICAL CLINIC
Entity Type:Organization
Organization Name:HOLY MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-375-5770
Mailing Address - Street 1:6910 CHETWOOD DR
Mailing Address - Street 2:STE. B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-5612
Mailing Address - Country:US
Mailing Address - Phone:713-661-1935
Mailing Address - Fax:281-247-1519
Practice Address - Street 1:6910 CHETWOOD DR
Practice Address - Street 2:STE. B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5612
Practice Address - Country:US
Practice Address - Phone:713-661-1935
Practice Address - Fax:281-247-1519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization