Provider Demographics
NPI:1760893150
Name:PIONEER MEDICAL CLINIC, PLLC
Entity Type:Organization
Organization Name:PIONEER MEDICAL CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FAHAD
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:NAVEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-300-4644
Mailing Address - Street 1:10700 STANCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-4307
Mailing Address - Country:US
Mailing Address - Phone:832-300-4644
Mailing Address - Fax:832-300-4649
Practice Address - Street 1:10700 STANCLIFF RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-4307
Practice Address - Country:US
Practice Address - Phone:832-300-4644
Practice Address - Fax:832-300-4649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty