1134433642 NPI number — RIVER OAKS EMERGENCY PHYSICIAN

Table of content: (NPI 1134433642)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134433642 NPI number — RIVER OAKS EMERGENCY PHYSICIAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RIVER OAKS EMERGENCY PHYSICIAN
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:
1134433642
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2320 S SHEPHERD 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:
77019-7014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-526-2320
Provider Business Mailing Address Fax Number:
713-526-2322

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2320 S SHEPHERD DR
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:
77019-7014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-526-2320
Provider Business Practice Location Address Fax Number:
713-526-2322
Provider Enumeration Date:
07/27/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LUNA
Authorized Official First Name:
HORTENCIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
713-526-2320

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1720009590 . This is a "WESLEY NAHM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1194839530 . This is a "JAIME MIRAVITE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1235364167 . This is a "ALLISON DAUM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1285688093 . This is a "ANGELA LEWIS-TRAYLOR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1295849727 . This is a "VICTORIA ALEXANDER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1417180324 . This is a "AKBAR AMIRAFSHARI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1417903956 . This is a "HORTENCIA LUNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com