1932391315 NPI number — HEMONC PHYSICIANS ENTERPRISE, PA

Table of content: (NPI 1932391315)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932391315 NPI number — HEMONC PHYSICIANS ENTERPRISE, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEMONC PHYSICIANS ENTERPRISE, 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:
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:
1932391315
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15402 BAY COVE CT
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:
77059-5820
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-464-2832
Provider Business Mailing Address Fax Number:
281-464-2835

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11914 ASTORIA BLVD
Provider Second Line Business Practice Location Address:
STE: 355
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77089-6064
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-464-2832
Provider Business Practice Location Address Fax Number:
281-464-2835
Provider Enumeration Date:
08/09/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NADEEM
Authorized Official First Name:
SAHBA
Authorized Official Middle Name:
Q
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
281-464-2832

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  J7109 , 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)