Organization Active NPI

Clear Lake Oncology PLLC

  • Medical Oncology Physician
  • Webster, TX
National Provider Identifier
1437543626
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
CLEAR LAKE ONCOLOGY PLLC
Practice address
600 N Kobayashi Ste 310
Webster, TX 77598
Phone
(281) 724-8335
Fax
(281) 724-1861
NPI assigned
Mar 25, 2015
Last updated
Jun 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeanne Frazier
Title
Executive Director
Phone
(281) 724-7145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X NU Primary

Addresses

Primary practice location

600 N Kobayashi Ste 310
Webster, TX 77598

Mailing address

PO Box 58778
Webster, TX 77598-8778
Phone (281) 724-8335

Other identifiers 2

IdentifierTypeStateIssuer
1346569316OtherTXNPI
1639360829OtherTXNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150514001219 TX Part B Supplier - Clinic/Group Practice 1557681558 Receives reassigned benefits from 2 practitioners
Practice locations: Webster, TX

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

11950 Old Galveston Rd
Ste 102
Houston, TX 77034
Phone (713) 947-2142

600 N Kobayashi
Ste 309
Webster, TX 77598
Phone (281) 724-8332

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1437543626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58778",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775988778",
            "telephone_number": "281-724-8335",
            "fax_number": "281-724-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N KOBAYASHI STE 310",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "77598",
            "telephone_number": "281-724-8335",
            "fax_number": "281-724-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR LAKE ONCOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "281-724-7145"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1346569316",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1639360829",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.