NPIMap

Organization Active NPI

University of Houston, Clear Lake

  • Community/Behavioral Health Agency
  • Houston, TX
National Provider Identifier
1639476351
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
UNIVERSITY OF HOUSTON, CLEAR LAKE
Practice address
2700 Bay Area Blvd.
MC 245
Houston, TX 77058-1098
Phone
(281) 283-3437
NPI assigned
Feb 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Authorized official

Name
Kally Berdeaux, BCBA, LBA
Title
Program Manager
Phone
(281) 283-3452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2700 Bay Area Blvd.
MC 245
Houston, TX 77058-1098

Mailing address

2700 Bay Area Blvd.
MC 245
Houston, TX 77058-1098
Phone (281) 283-3437

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
45D0692701Univ of Houston Clear Lake HLTH Ctr2700 Bay Area Blvd # 260, Houston, TX 77058Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Univ of Houston Optomet12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2700 Bay Area Blvd
#245
Houston, TX 77058
Phone (281) 283-3437

Practitioners & affiliated clinicians

Practitioners 1

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": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1639476351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BAY AREA BLVD.",
            "address_2": "MC 245",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770581098",
            "telephone_number": "281-283-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 BAY AREA BLVD.",
            "address_2": "MC 245",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770581098",
            "telephone_number": "281-283-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF HOUSTON, CLEAR LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "BERDEAUX",
        "authorized_official_first_name": "KALLY",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "281-283-3452",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.