Healthcare Provider Details

I. General information

NPI: 1790737187
Provider Name (Legal Business Name): CLINTON H DOERR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6560 FANNIN ST STE 1632
HOUSTON TX
77030-2734
US

IV. Provider business mailing address

PO BOX 4346 DEPT 794
HOUSTON TX
77210-4346
US

V. Phone/Fax

Practice location:
  • Phone: 713-255-4000
  • 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 NumberK2006
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberK2006
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberK2006
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: