Clear Lake ENT, P.a

Primary specialty

SpecialistTaxonomy code 174400000X

License

J4653 Issued in TX

Legal business name

CLEAR LAKE ENT, P.A

Practice address

18100 Saint John Dr
Suite 240
Houston, TX 77058-3631

Phone

(281) 335-7755

Fax

(281) 335-7766

NPI assigned

Oct 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Alfredo Jimenez, M.D.

Title

Owner

Phone

(281) 335-7755

Specialties & licenses 1

Addresses

Other identifiers 4

Practitioners 1

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

• Thomas Andrew Downing, M.S., CCC/A

  • Audiologist
  • Houston, TX
  • NPI 1932354149
  NPD (past)

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1629267752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 580451",
            "address_2": "LOCK BOX 157102",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772580451",
            "telephone_number": "281-335-7755",
            "fax_number": "281-335-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18100 SAINT JOHN DR",
            "address_2": "SUITE 240",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770583631",
            "telephone_number": "281-335-7755",
            "fax_number": "281-335-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR LAKE ENT, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "ALFREDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-335-7755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "J4653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8K6340",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "0029KV",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "F68110",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10023864",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clear Imaging and Diagnostics LLC
• Clear Imaging North LLC
• Clear Lake Complete Chiropractic
• Clear Lake Counseling Servicespcinc
• Clear Lake Dialysis Center
• Clear Lake Eye Center LLP
• Clear Lake Facial Aesthetic & Reconstructive Surgery
• Clear Lake Family Physicians, LLP
• Clear Lake Integrative Medicine
• Clear Lake Modern Dentistry, PC

• All providers in Houston, TX
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.