1952447302 NPI number — KOMAL F STOERR MDPA

Table of content: (NPI 1952447302)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952447302 NPI number — KOMAL F STOERR MDPA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KOMAL F STOERR MDPA
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:
DERMATOLOGY SPECIALISTS OF HOUSTON
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:
1952447302
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 25368
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:
77265-5368
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-971-7687
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5420 WEST LOOP S
Provider Second Line Business Practice Location Address:
SUITE 4500
Provider Business Practice Location Address City Name:
BELLAIRE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77401-2107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-529-8787
Provider Business Practice Location Address Fax Number:
713-529-8790
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STOERR
Authorized Official First Name:
KOMAL
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
832-971-7687

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  K1175 , 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)





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