Healthcare Provider Details

I. General information

NPI: 1053224014
Provider Name (Legal Business Name): CLINICAL CROWN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 LOUISIANA ST STE 900
HOUSTON TX
77002-1062
US

IV. Provider business mailing address

440 LOUISIANA ST STE 900
HOUSTON TX
77002-1062
US

V. Phone/Fax

Practice location:
  • Phone: 832-464-5146
  • Fax:
Mailing address:
  • Phone: 832-464-5146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. IMANI SPENCE
Title or Position: OWNER
Credential:
Phone: 832-464-5146