Provider Demographics
NPI:1720480775
Name:EVER BRIGHT MEDICAL CLINIC LLC
Entity Type:Organization
Organization Name:EVER BRIGHT MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:EJECKAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-492-0895
Mailing Address - Street 1:8200 WEDNESBURY LN
Mailing Address - Street 2:SUITE 405
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2925
Mailing Address - Country:US
Mailing Address - Phone:713-492-0895
Mailing Address - Fax:
Practice Address - Street 1:8200 WEDNESBURY LN
Practice Address - Street 2:SUITE 405
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2925
Practice Address - Country:US
Practice Address - Phone:713-492-0895
Practice Address - Fax:713-492-0926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty