Provider Demographics
NPI:1912348814
Name:CLEVELAND PHYSICAIN ASSOCIATES
Entity Type:Organization
Organization Name:CLEVELAND PHYSICAIN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-549-5704
Mailing Address - Street 1:1806 HUMBLE PLACE DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5277
Mailing Address - Country:US
Mailing Address - Phone:281-446-9676
Mailing Address - Fax:281-446-8690
Practice Address - Street 1:1806 HUMBLE PLACE DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5277
Practice Address - Country:US
Practice Address - Phone:281-446-9676
Practice Address - Fax:281-446-8690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0133208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty