| Prime Vital | |
|
2017 N Frazier St Ste G8a Conroe TX 77301-1248 | |
| (936) 703-3468 | |
| (936) 703-3469 |
| Full Name | Prime Vital |
|---|---|
| Speciality | Clinic/Center |
| Location | 2017 N Frazier St Ste G8a, Conroe, Texas |
| Authorized Official Name and Position | Clara Ike (OWNER) |
| Authorized Official Contact | 8326566790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Vital 2257 N Loop 336 W Ste 140-246 Conroe TX 77304-3566 Ph: (832) 656-6790 | Prime Vital 2017 N Frazier St Ste G8a Conroe TX 77301-1248 Ph: (936) 703-3468 |
| NPI Number | 1184501413 |
|---|---|
| Provider Enumeration Date | 08/19/2025 |
| Last Update Date | 08/04/2026 |
| Certification Date | 08/04/2026 |
| Medicare PECOS PAC ID | 9436635414 |
|---|---|
| Medicare Enrollment ID | O20260108004151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184501413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Clara Binta Ike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699278960 PECOS PAC ID: 3577738558 Enrollment ID: I20260108004194 |
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