Provider Demographics
NPI:1447255179
Name:OUTPATIENT CLINICAL CARE, P.A.
Entity type:Organization
Organization Name:OUTPATIENT CLINICAL CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-218-7300
Mailing Address - Street 1:7777 SOUTHWEST FWY STE 650
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1809
Mailing Address - Country:US
Mailing Address - Phone:713-218-7300
Mailing Address - Fax:713-218-7221
Practice Address - Street 1:7777 SOUTHWEST FWY STE 650
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1809
Practice Address - Country:US
Practice Address - Phone:713-218-7300
Practice Address - Fax:713-218-7221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 208000000X
TXJ5851207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092401101Medicaid
TX092401102Medicaid
TX092401101Medicaid