1790001055 NPI number — HOUSTON INFECTIOUS DISEASES CONSULTANTS PA

Table of content: ALEXIS HOFFMAN (NPI 1043888241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790001055 NPI number — HOUSTON INFECTIOUS DISEASES CONSULTANTS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOUSTON INFECTIOUS DISEASES CONSULTANTS PA
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:
1790001055
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 690565
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:
77269-0565
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-850-1190
Provider Business Mailing Address Fax Number:
713-850-1327

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
605 HOLDERRIETH BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOMBALL
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77375-6445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-422-1316
Provider Business Practice Location Address Fax Number:
832-422-1318
Provider Enumeration Date:
04/12/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MOTIWALA
Authorized Official First Name:
MUHAMMAD
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
832-422-1316

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 127389806 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com