1386847663 NPI number — ONCOLOGY CONSULTANTS, P. A.

Table of content: (NPI 1386847663)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386847663 NPI number — ONCOLOGY CONSULTANTS, P. A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONCOLOGY CONSULTANTS, P. A.
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:
1386847663
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4418
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:
77210-4418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-827-9525
Provider Business Mailing Address Fax Number:
713-827-1380

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17520 W GRAND PKWY S STE 460
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77479-4983
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-491-5511
Provider Business Practice Location Address Fax Number:
281-491-5513
Provider Enumeration Date:
06/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CAMPOS
Authorized Official First Name:
LUIS
Authorized Official Middle Name:
T.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
713-827-9525

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 121365408 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 121365401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 121365405 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: C18568 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com