Healthcare Provider Details

I. General information

NPI: 1609393388
Provider Name (Legal Business Name): NEW ERA CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 RICHMOND AVE
HOUSTON TX
77098-3604
US

IV. Provider business mailing address

1716 RICHMOND AVE
HOUSTON TX
77098-3604
US

V. Phone/Fax

Practice location:
  • Phone: 832-498-3245
  • Fax:
Mailing address:
  • Phone: 832-498-3245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberQ5521
License Number StateTX

VIII. Authorized Official

Name: EMMANUEL OBIORA OKOLO
Title or Position: DIRECTOR
Credential: MD
Phone: 832-498-3245