MEDICARE: CHCA CLEAR LAKE LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0002X	Emergency Care Clinic/Center

General Provider Information

NPI Number	:	1114869005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHCA CLEAR LAKE LP

Provider Business Mailing Address
First Line	:	225 E PARKWOOD AVE
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-5145
Country	:	US
Telephone Number	:	281-816-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 E PARKWOOD AVE
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-5145
Country	:	US
Telephone Number	:	281-816-8400
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	BRYAN SHEPHERD
Credential	:
Telephone Number	:	281-332-2511

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/10/2026

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Directions to “CHCA CLEAR LAKE LP ” Practice Location

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