Provider Demographics
NPI:1669998415
Name:CLEAR LAKE WOUND CARE PLLC
Entity type:Organization
Organization Name:CLEAR LAKE WOUND CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BABA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-816-3091
Mailing Address - Street 1:PO BOX 58378
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8378
Mailing Address - Country:US
Mailing Address - Phone:281-316-3091
Mailing Address - Fax:832-905-3942
Practice Address - Street 1:600 N KOBAYASHI STE 212
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4841
Practice Address - Country:US
Practice Address - Phone:281-816-3091
Practice Address - Fax:832-905-3942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty