1891797999 NPI number — OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES, PLLC

Table of content: (NPI 1891797999)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891797999 NPI number — OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES, PLLC
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:
OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES, P.A.
Provider Other Organization Name Type Code:
4
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:
1891797999
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4048
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:
77210-4048
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-512-7000
Provider Business Mailing Address Fax Number:
713-512-7082

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7900 FANNIN ST
Provider Second Line Business Practice Location Address:
SUITE 4000
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77054-2934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-512-7000
Provider Business Practice Location Address Fax Number:
713-512-7082
Provider Enumeration Date:
06/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PENA
Authorized Official First Name:
RORY
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING
Authorized Official Telephone Number:
713-512-7027

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  D9508 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207VE0102X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VG0400X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085U0001X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 144808601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 147769701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: CN9938 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 079778901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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