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General NPI Number Information
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NPI Number | 1467726281
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Entity Type | Organization
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Legal Business Name | CLEAR DERMATOLOGY PLLC
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Dates
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Enumeration Date | 02/24/2012
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 17756 KATY FWY STE G1
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City | HOUSTON
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State | TX
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Zip | 77094-1380
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Country | US
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Telephone | 832-772-3330
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Fax | 832-772-3332
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Provider Business Mailing Address
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Address Line | 17756 KATY FREEWAY #G1
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City | HOUSTON
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State | TX
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Zip | 77094
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Country | US
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Telephone | 832-772-3330
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Fax | 832-772-3332
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LIBBYETTE E WRIGHT
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Credential | MD
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Telephone | 713-984-0010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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