CLEAR LAKE PEDIATRIC NEPHROLOGY, P.A. (NPI# 1912263021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912263021 |
| Entity Type | Organization |
| Organization Name | CLEAR LAKE PEDIATRIC NEPHROLOGY, P.A. |
| Practice Address |
400 Medical Center Blvd Suite 118 Webster TX 77598-4235 |
| Mailing Address |
2803 Harvest Hill Ct Autumn Creek Friendswood TX 77546-5099 |
| Practice Telephone | 2813380700 |
| Mailing Telephone | 2815577308 |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2012-05-11 |
| Authorized Official Name | DR. NASREEN AZAM (PRESIDENT/OWNER) |
| Authorized Official Telephone | 2815577308 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
Allopathic & Osteopathic Physicians |
| Street Address |
400 MEDICAL CENTER BLVD SUITE 118 |
| City | WEBSTER |
| State | TX |
| Zip Code | 77598-4235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386647501 | Home Care Professional Services, Inc. | Home Health | 400 Medical Center Blvd, Ste 201, Webster, TX 77598-4227 | 2005-05-23 |
| 1285895722 | Kausar Suleman Md Pa | Internal Medicine | 400 Medical Center Blvd, Suite 108, Webster, TX 77598-4235 | 2008-06-18 |
| 1659464725 | Kausar Suleman | Internal Medicine | 400 Medical Center Blvd, Suite 108, Webster, TX 77598-4235 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816376 | Philippe Joseph Dentino | Physical Therapist | 14520 Tx-3, Webster, TX 77598 | 2020-09-21 |
| 1093324428 | Complete Care Obgyn and Family Medicine Pllc | Obstetrics & Gynecology | 1408 W Nasa Parkway, Ste A, Webster, TX 77598 | 2020-07-31 |
| 1366082562 | Ryse Chiropractic Plus Spa LLC | Chiropractor | 780 Clear Lake City Blvd., Bldg. 1-a, Webster, TX 77598 | 2020-01-15 |
| 1770133837 | Wellness Vip, LLC | Occupational Therapist | 1011 W.bay Area Blvd Ste. 1102, Webster, TX 77598 | 2019-09-19 |
| 1689236341 | Houston Advanced Surgical Services, LLC | Physician Assistant | 500 W. Medical Center Blvd., Webster, TX 77598 | 2019-07-02 |
| 1528524295 | Luxury Dialycare Pllc | Clinic/Center | 600 N. Kobayashi Road, Suite 108, Webster, TX 77598 | 2019-02-18 |
| 1124501879 | Vip Vision LLC | Optometrist | 1310 Jasmine St., Webster, TX 77598 | 2018-09-10 |
| 1073094322 | Asha Mathew | Family Medicine | Brain and Spine Clinic Pa, Suite 250, 400 W Medical Center Blvd, Webster, TX 77598 | 2018-08-24 |
| 1760960991 | Bryce Ethan Jeffrey | Physical Therapist | 1416 Fm 528 Ste A, Webster, TX 77598 | 2018-07-31 |
| 1841777281 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1310 Jasmine Avenue, Webster, TX 77598 | 2018-07-27 |
| Find all providers in zip 77598 | ||||
| Taxonomy Code | 2080P0210X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Nephrology |
| A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265859755 | Peace Dorothy Imani | Pediatrics | 1102 Bates Ave., Baylor College of Medicine, Houston, Tx, TX 77030 | 2014-03-24 |
| 1356762256 | L. L. Hill | Pediatrics | 4906 Tilbury, Houston, TX 77056-2214 | 2013-12-18 |
| 1154640324 | Khurrum Siddique | Pediatrics | 2821 Michaelangelo Dr Ste 101, Edinburg, TX 78539-1411 | 2010-05-26 |
| 1194053496 | Jack Moncrief Group, Pa | Pediatrics | 800 West 34th Street, Suite 101, Austin, TX 78705 | 2009-11-24 |
| 1922272236 | Alvaro Hernando Orjuela | Pediatrics | 1102 Bates Ave Ste 260, Houston, TX 77030-2619 | 2008-04-17 |
| 1417157215 | Catherine Joseph | Pediatrics | 1102 Bates Ave Ste 245, Houston, TX 77030-2619 | 2007-07-19 |
| 1003916172 | Jose F Pascual-baralt | Pediatrics | 7419 Round Mtn, San Antonio, TX 78255-1159 | 2006-09-25 |
| 1962519033 | Mazen Arar | Pediatrics | 333 N Santa Rosa, 2nd Fl, San Antonio, TX 78207 | 2006-08-24 |
| 1376905596 | Caroline Elizabeth Jarrell | Pediatrics | 6701 Fannin St, Houston, TX 77030-2608 | 2016-03-26 |
| 1093154379 | Ali Kareem Kurady | Pediatrics | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2013-06-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.