1447372123 NPI number — PEDIATRIC HEALTHCARE OF NORTHWEST HOUSTON PA

Table of content: (NPI 1447372123)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447372123 NPI number — PEDIATRIC HEALTHCARE OF NORTHWEST HOUSTON PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEDIATRIC HEALTHCARE OF NORTHWEST HOUSTON PA
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:
KHOZEMA PALANPURWALA MD
Provider Other Organization Name Type Code:
5
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:
1447372123
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11840 FM 1960 RD W
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:
77065-3840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-912-7044
Provider Business Mailing Address Fax Number:
832-912-7033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12015 LOUETTA RD STE 100
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:
77070-1148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-664-2152
Provider Business Practice Location Address Fax Number:
281-257-3514
Provider Enumeration Date:
04/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PALANPURWALA
Authorized Official First Name:
KHOZEMA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
281-357-5115

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  J8338 , 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: 035826904 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134124779 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1346554086 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1275835530 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1346247301 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1922115534 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 039452004 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1508848995 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1841389897 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 128256808 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1295737286 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1780651133 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 160185803 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 218384001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1841389897 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 194471202 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1992772990 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 130902308 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1386611721 . This is a "NPI" identifier . This identifiers is of the category "OTHER".




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