1457450231 NPI number — HOUSTON,TOTAL ORTHOPEDICS P.A

Table of content: (NPI 1457450231)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457450231 NPI number — HOUSTON,TOTAL ORTHOPEDICS P.A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOUSTON,TOTAL ORTHOPEDICS 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:
1457450231
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 924587
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:
77292-4587
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-586-6778
Provider Business Mailing Address Fax Number:
713-586-6752

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 CYPRESS STATION DR
Provider Second Line Business Practice Location Address:
STE 248
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77090-1630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-586-6705
Provider Business Practice Location Address Fax Number:
713-586-6752
Provider Enumeration Date:
09/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KELLNER
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
C
Authorized Official Title or Position:
DIRECTOR OF CREDENTIALING
Authorized Official Telephone Number:
713-586-6705

Provider Taxonomy Codes

  • Taxonomy code: 207XS0106X , with the licence number:  E6403 , 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: 0078MY . This is a "BC BS GROUP NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com