| NPI | 1225562887 |
|---|---|
| Doing Business As | CLEAR LAKE MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | MANAN S SHUKLA President 612-306-1509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TX N9300) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-05-02 |