| NPI | 1922513134 |
|---|---|
| Former Legal Business Name | CLEARLAKE IMAGING LLC |
| Entity Type | Organization |
| Authorized Contact | NIDHI SHARMA Office Manager 832-667-8132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QR0200X Clinic/Center Radiology |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2018-03-17 |