Healthcare Provider Details

I. General information

NPI: 1316074438
Provider Name (Legal Business Name): THE PEARLAND CLINIC P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15419 ROCKY OAK CT
HOUSTON TX
77059-3128
US

IV. Provider business mailing address

15419 ROCKY OAK CT
HOUSTON TX
77059-3128
US

V. Phone/Fax

Practice location:
  • Phone: 713-436-9800
  • Fax: 713-436-5551
Mailing address:
  • Phone: 713-436-9800
  • Fax: 713-436-5551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK6680
License Number StateTX

VIII. Authorized Official

Name: DR. KIRANCHANDRA MAGANLAL PATEL
Title or Position: DIRECTOR
Credential: MD
Phone: 713-436-9800