Provider Demographics
NPI:1821054826
Name:CLEAR LAKE FAMILY PHYSICIANS, LLP
Entity Type:Organization
Organization Name:CLEAR LAKE FAMILY PHYSICIANS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:E
Authorized Official - Last Name:POUZAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:281-486-7900
Mailing Address - Street 1:14903 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2603
Mailing Address - Country:US
Mailing Address - Phone:281-486-7900
Mailing Address - Fax:281-286-8110
Practice Address - Street 1:14903 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-2603
Practice Address - Country:US
Practice Address - Phone:281-486-7900
Practice Address - Fax:281-286-8110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00F46EMedicare ID - Type UnspecifiedGROUP ID