MEDICARE: THE PEARLAND CLINIC P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	K6680	TX

General Provider Information

NPI Number	:	1316074438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PEARLAND CLINIC P.A.

Provider Business Mailing Address
First Line	:	15419 ROCKY OAK CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-3128
Country	:	US
Telephone Number	:	713-436-9800
Fax Number	:	713-436-5551

Provider Business Practice Location Address
First Line	:	15419 ROCKY OAK CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-3128
Country	:	US
Telephone Number	:	713-436-9800
Fax Number	:	713-436-5551

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. KIRANCHANDRA MAGANLAL PATEL
Credential	:	MD
Telephone Number	:	713-436-9800

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	08/22/2020

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