1205959988 NPI number — DR. W KENNETH HORWITZ D.D.S.

Table of content: DR. W KENNETH HORWITZ D.D.S. (NPI 1205959988)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205959988 NPI number — DR. W KENNETH HORWITZ D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORWITZ
Provider First Name:
W
Provider Middle Name:
KENNETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
M

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:
1205959988
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
171 SAGE RD
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:
77056-1417
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-572-4256
Provider Business Mailing Address Fax Number:
713-666-2485

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8811 FRANKWAY DR
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77096-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-666-2333
Provider Business Practice Location Address Fax Number:
713-666-2485
Provider Enumeration Date:
04/09/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  7065 , 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)