Provider Demographics
NPI:1508003286
Name:CLEAR LAKE SURGERY CENTER, PLLC
Entity Type:Organization
Organization Name:CLEAR LAKE SURGERY CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:SUKKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-990-8487
Mailing Address - Street 1:14018 AESTHETIC CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2373
Mailing Address - Country:US
Mailing Address - Phone:281-204-8017
Mailing Address - Fax:281-204-8018
Practice Address - Street 1:14018 AESTHETIC CIR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-2373
Practice Address - Country:US
Practice Address - Phone:281-204-8017
Practice Address - Fax:281-204-8018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7218261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical