1225024706 NPI number — ANESTHESIOLOGY CONSULTANTS OF HOUSTON PLLC

Table of content: (NPI 1225024706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225024706 NPI number — ANESTHESIOLOGY CONSULTANTS OF HOUSTON PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANESTHESIOLOGY CONSULTANTS OF HOUSTON PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225024706
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 203824
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77216-3824
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-358-8114
Provider Business Mailing Address Fax Number:
281-358-0609

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8850 LONG POINT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77055-3006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-827-1820
Provider Business Practice Location Address Fax Number:
713-468-7370
Provider Enumeration Date:
09/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
AVES
Authorized Official First Name:
TEODULO
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
713-827-1820

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  H7874 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207LP2900X , with the licence number: H7874 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00091K . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 090104302 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: CN6330 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00090K . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 090104301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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