Provider Demographics
NPI:1346033032
Name:EAST BERNARD PRIMEMED CLINIC
Entity type:Organization
Organization Name:EAST BERNARD PRIMEMED CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMACHANDRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PALANISAMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-579-8620
Mailing Address - Street 1:876 S DILL ST
Mailing Address - Street 2:
Mailing Address - City:EAST BERNARD
Mailing Address - State:TX
Mailing Address - Zip Code:77435-8688
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:876 S DILL ST
Practice Address - Street 2:
Practice Address - City:EAST BERNARD
Practice Address - State:TX
Practice Address - Zip Code:77435-8688
Practice Address - Country:US
Practice Address - Phone:407-579-8620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care