Provider Demographics
NPI:1639582984
Name:CLINICA ROYALE LLC
Entity type:Organization
Organization Name:CLINICA ROYALE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OSINLOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-603-5543
Mailing Address - Street 1:8877 LAKES AT 610 DR
Mailing Address - Street 2:213
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2591
Mailing Address - Country:US
Mailing Address - Phone:972-603-5543
Mailing Address - Fax:
Practice Address - Street 1:8877 LAKES AT 610 DR
Practice Address - Street 2:213
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2591
Practice Address - Country:US
Practice Address - Phone:972-603-5543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center