Healthcare Provider Details

I. General information

NPI: 1063464402
Provider Name (Legal Business Name): PULMONARY CRITICAL CARE AND SLEEP MEDICINE CONSULTANTS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6560 FANNIN ST STE 1632
HOUSTON TX
77030-2734
US

IV. Provider business mailing address

DEPT 794 PO BOX 4346
HOUSTON TX
77210-4346
US

V. Phone/Fax

Practice location:
  • Phone: 713-255-4066
  • Fax: 713-255-4050
Mailing address:
  • Phone: 713-255-4000
  • Fax: 713-255-4050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CLINTON HAROLD DOERR
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 713-255-4000