1770728826 NPI number — HOUSTON DIAGNOSTIC CATH LAB LP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770728826 NPI number — HOUSTON DIAGNOSTIC CATH LAB LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOUSTON DIAGNOSTIC CATH LAB LP
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:
TRAVIS CENTER ANGIOGRAPHY
Provider Other Organization Name Type Code:
3
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:
1770728826
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6655 TRAVIS ST
Provider Second Line Business Mailing Address:
SUITE 250
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030-1312
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-580-0401
Provider Business Mailing Address Fax Number:
713-580-0411

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16651 SOUTHWEST FWY
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77479-2345
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-580-0401
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MEDRANO
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
Authorized Official Title or Position:
BUSINESS OFFICE MANAGER
Authorized Official Telephone Number:
713-580-0402

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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