1457558702 NPI number — LONG POINT HEALTH & INJURY

Table of content: (NPI 1457558702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457558702 NPI number — LONG POINT HEALTH & INJURY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LONG POINT HEALTH & INJURY
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:
HEALTH & INJURY CENTERS
Provider Other Organization Name Type Code:
5
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:
1457558702
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7807 LONG POINT RD STE 305
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:
77055-3779
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-864-2787
Provider Business Mailing Address Fax Number:
713-864-2799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7807 LONG POINT RD
Provider Second Line Business Practice Location Address:
# 305
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77055-3779
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-864-2787
Provider Business Practice Location Address Fax Number:
713-864-2799
Provider Enumeration Date:
06/29/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KOWALSKI
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CLINIC DIRECTOR
Authorized Official Telephone Number:
713-864-2787

Provider Taxonomy Codes

  • Taxonomy code: 111NX0800X , with the licence number:  2889 , 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)