1033373949 NPI number — ONCOLOGY CONSULTANTS, P.A.

Table of content: (NPI 1033373949)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033373949 NPI number — ONCOLOGY CONSULTANTS, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONCOLOGY CONSULTANTS, P.A.
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:
6
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:
1033373949
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2130 W HOLCOMBE BLVD
Provider Second Line Business Mailing Address:
10TH FLOOR
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030-3305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-600-0900
Provider Business Mailing Address Fax Number:
713-600-0070

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2130 W HOLCOMBE BLVD
Provider Second Line Business Practice Location Address:
10TH FLOOR
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-3305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-600-0900
Provider Business Practice Location Address Fax Number:
713-600-0070
Provider Enumeration Date:
07/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
CAMPOS
Authorized Official First Name:
LUIS
Authorized Official Middle Name:
T
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
713-800-0656

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  26101 , 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)

  • Identifier: 4550489 . This is a "NCPDP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 190447602 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 350225 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 190447601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1033373949 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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