1730255001 NPI number — IPR HEALTHCARE SYSTEM INC

Table of content: (NPI 1730255001)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730255001 NPI number — IPR HEALTHCARE SYSTEM INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IPR HEALTHCARE SYSTEM INC
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:
1730255001
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1328 S LOOP W STE 100
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:
77054-4008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-592-6776
Provider Business Mailing Address Fax Number:
713-592-6780

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1328 S LOOP W STE 100
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:
77054-4008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-592-6776
Provider Business Practice Location Address Fax Number:
713-592-6780
Provider Enumeration Date:
11/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CALUSCOS
Authorized Official First Name:
PABLITO
Authorized Official Middle Name:
QUIZA
Authorized Official Title or Position:
ADMINISTRATOR CEO
Authorized Official Telephone Number:
713-896-6776

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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