1174989859 NPI number — ONCOLOGY CONSULTANTS, P. A.

Table of content: (NPI 1174989859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174989859 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:
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:
1174989859
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
902 FROSTWOOD DR
Provider Second Line Business Mailing Address:
SUITE 315
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77024-2420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-800-0656
Provider Business Mailing Address Fax Number:
713-827-1380

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1920 COUNTRY PLACE PKWY
Provider Second Line Business Practice Location Address:
SUITE 370
Provider Business Practice Location Address City Name:
PEARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77584-2282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-333-1400
Provider Business Practice Location Address Fax Number:
832-333-1499
Provider Enumeration Date:
01/11/2016

Additional Information

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3571671-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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