Healthcare Provider Details

I. General information

NPI: 1750765665
Provider Name (Legal Business Name): CHIC/LARKIN VENTURES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2015
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 WARNER DR
GOLDEN CO
80401-5297
US

IV. Provider business mailing address

6800 WEST LOOP S SUITE 300
BELLAIRE TX
77401-4528
US

V. Phone/Fax

Practice location:
  • Phone: 713-838-0800
  • Fax: 713-833-0887
Mailing address:
  • Phone: 713-838-0800
  • Fax: 713-833-0887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KELLY LARKIN
Title or Position: OWNER
Credential: M.D.
Phone: 713-838-0800