1891947677 NPI number — SAO AIRLINE OB-GYN

Table of content: (NPI 1891947677)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891947677 NPI number — SAO AIRLINE OB-GYN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAO AIRLINE OB-GYN
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:
1891947677
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6031 AIRLINE DR
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:
77076-4209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-694-6600
Provider Business Mailing Address Fax Number:
713-694-6616

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9180 KATY FWY STE 202
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:
77055-7443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-647-7700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/11/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MIGUEL
Authorized Official First Name:
BRENO
Authorized Official Middle Name:
L
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
713-694-6600

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)