1699927590 NPI number — PASNAR HOUSTON LLC

Table of content: (NPI 1699927590)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699927590 NPI number — PASNAR HOUSTON LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PASNAR HOUSTON LLC
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:
1699927590
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPT 2555 PO BOX 4228
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:
77210-4228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-960-6692
Provider Business Mailing Address Fax Number:
713-960-6691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9901 TOWN PARK DR
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:
77036-2343
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-773-0556
Provider Business Practice Location Address Fax Number:
713-773-1388
Provider Enumeration Date:
10/22/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SANDUJA
Authorized Official First Name:
SOURABH
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
713-773-0556

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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