Provider Demographics
NPI:1669766531
Name:HOLY CROSS MEDICAL CLINIC L C
Entity type:Organization
Organization Name:HOLY CROSS MEDICAL CLINIC L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-902-2525
Mailing Address - Street 1:4315 LOCKWOOD DR
Mailing Address - Street 2:UNIT 5
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-4117
Mailing Address - Country:US
Mailing Address - Phone:832-638-9775
Mailing Address - Fax:
Practice Address - Street 1:4315 LOCKWOOD DR
Practice Address - Street 2:UNIT 5
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-4117
Practice Address - Country:US
Practice Address - Phone:832-638-9775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty