Surgical Specialists of Clear Lake PLLC
Organization Active NPI Surgery Physician · Webster, TX
NPI 1720263221 · NPPES record last updated Nov 21, 2025
Key facts
- NPI
- 1720263221
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- SURGICAL SPECIALISTS OF CLEAR LAKE PLLC
- Practice address
- 200 Medical Center Blvd
Ste 101
Webster, TX 77598-4226 - Phone
- (281) 332-4596
- NPI assigned
- Jan 2, 2008
- Organization subpart
- No
Authorized official
- Name
- Nicholas Wadlington
- Title
- Group Vice President
- Phone
- (615) 372-7332
Practitioners 16
-
Hannan Chaugle, M.D.
-
Khoi H Du, M.D.
-
Khaja Moinuddeen, MD
-
Dhruvil Shah, M.D.
-
In Soo Yo, MD
-
Rebecca Buckner, PHYSICIAN ASSISTANT
-
Cari Janella Graybill, PA-C
-
Kelly Gilmore, MD
-
Tulika Singh, PHYSICIAN ASSISTANT
-
Richard Ehlers, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080428000167 | TX | Part B Supplier - Clinic/Group Practice | 6103904461 |
Receives reassigned benefits from 14 practitioners Practice locations: Pasadena, TX; Pearland, TX; Webster, TX; Humble, TX |
National Provider Directory
Locations
2907 Broadway St
Ste 100
Pearland, TX 77581
333 N Texas Ave
Ste 100
Webster, TX 77598
Phone (281) 335-1700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
200 Medical Center Blvd
Ste 101
Webster, TX 77598-4226
Mailing address
2000 Health Park Dr
Brentwood, TN 37027-4692
Phone (615) 373-7406
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 193267501 | Medicaid | TX | |
| DH1753 | Other | TX | RAILROAD MEDICARE |
Other providers in Webster, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.