| Organization Name: | I 45 MEDICAL CLINIC, LLC. |
| NPI Number: | 1235450644 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANGELO SOTO (OWNER) |
| Mailing Address: | 4141 North Fwy Suite # 100 Houston |
| State: | TX US |
| Postal Code: | 770224208 |
| Phone Number: | 7136990900 |
| Fax Number: | 7136990903 |
| NPI Enumeration Date: | 06/21/2010 |
| NPI Last Update Date: | 06/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |