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NPI Code Detail

MEDICARE: NEW ERA CLINIC PLLC

MEDICARE: NEW ERA CLINIC PLLC
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
1208D00000XGeneral Practice Physician
2207R00000XInternal Medicine PhysicianQ5521TX

General Provider Information

NPI Number : 1609393388
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW ERA CLINIC PLLC
Provider Business Mailing Address
First Line : 1716 RICHMOND AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77098-3604
Country : US
Telephone Number : 832-498-3245
Fax Number :
Provider Business Practice Location Address
First Line : 1716 RICHMOND AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77098-3604
Country : US
Telephone Number : 832-498-3245
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : EMMANUEL OBIORA OKOLO
Credential : MD
Telephone Number : 832-498-3245
Provider Enumeration Date : 08/24/2017
Last Update Date : 07/21/2022

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Directions to “NEW ERA CLINIC PLLC ” Practice Location

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