Provider Demographics
NPI:1336739671
Name:EZ HOME CLINIC, LLC
Entity Type:Organization
Organization Name:EZ HOME CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:EGESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-651-7976
Mailing Address - Street 1:9337 KATY FWY # 7053
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1542
Mailing Address - Country:US
Mailing Address - Phone:346-219-9216
Mailing Address - Fax:
Practice Address - Street 1:9337 KATY FWY # 7053
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1542
Practice Address - Country:US
Practice Address - Phone:346-219-9216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty