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SOUTH MAIN CLINIC INC NPI 1326068933


NPI Information

NPI: 1326068933
Provider Name: SOUTH MAIN CLINIC, INC
Classification: Legal Medicine - 173000000X
Entity Type: Organization

CLIA Number: 45D1038312

Address:
12333 MAIN ST
HOUSTON, TX
ZIP 77035
Phone: (713) 729-7600
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SOUTH MAIN CLINIC, INC is a legal medicine in Houston, TX. The provider is the specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. SOUTH MAIN CLINIC, INC NPI is 1326068933. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12333 MAIN ST
HOUSTON, TX
ZIP 77035-205
Phone: (713) 729-7600
Fax: (713) 729-7603

The provider's authorized official is Alvaro Pinilla .
The authorized official title is President Owner and has the following contact phone number (713) 729-7600.

The CLIA number assigned to this NPI record is 45D1038312 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2006 and was last updated on 4/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral PracticeNo
2173000000XLegal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100288YMEDICARE ID-TYPE UNSPECIFIEDTEXASGROUP
20087MGOTHERTEXASBCBS
3=========OTHERTEXASFACILITY
41427078674OTHERTEXASDR. MONTGOMERY NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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