Organization Active NPI

Endocrinology Clinic at Clear Lake Specialties PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Webster, TX
National Provider Identifier
1578032363
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ENDOCRINOLOGY CLINIC AT CLEAR LAKE SPECIALTIES PLLC
Practice address
600 N Kobayashi Ste 312
Webster, TX 77598-4841
Phone
(281) 724-8333
Fax
(281) 724-1861
NPI assigned
Nov 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Authorized official

Name
Mohammad J Baba
Title
Owner
Phone
(281) 724-8333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

600 N Kobayashi Ste 312
Webster, TX 77598-4841

Mailing address

PO Box 57336
Webster, TX 77598-7336
Phone (281) 724-8333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190218002655 TX Part B Supplier - Clinic/Group Practice 6608114517 Receives reassigned benefits from 5 practitioners
Practice locations: Houston, TX; Webster, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2157121Endocrinology Clinic at Clear Lake600 N Kobayashi Suite 312, Webster, TX 77598Certificate of waiverOct 29, 2026

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555545600000",
    "number": "1578032363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57336",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775987336",
            "telephone_number": "281-724-8333",
            "fax_number": "281-724-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N KOBAYASHI STE 312",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984841",
            "telephone_number": "281-724-8333",
            "fax_number": "281-724-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINOLOGY CLINIC AT CLEAR LAKE SPECIALTIES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-21",
        "last_updated": "2019-04-18",
        "status": "A",
        "authorized_official_last_name": "BABA",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-724-8333"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.