1992842140 NPI number — NORTHWEST HOUSTON SURGICAL ASSOCIATION

Table of content: (NPI 1992842140)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992842140 NPI number — NORTHWEST HOUSTON SURGICAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHWEST HOUSTON SURGICAL ASSOCIATION
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:
NHSA
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:
1992842140
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21216 NORTHWEST FWY
Provider Second Line Business Mailing Address:
SUITE #250
Provider Business Mailing Address City Name:
CYPRESS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77429-1439
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-426-2400
Provider Business Mailing Address Fax Number:
713-426-3204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21216 NORTHWEST FWY
Provider Second Line Business Practice Location Address:
SUITE #250
Provider Business Practice Location Address City Name:
CYPRESS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77429-1439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-426-2400
Provider Business Practice Location Address Fax Number:
713-426-3204
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CHARGOIS
Authorized Official First Name:
PAULETTE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ADMIN
Authorized Official Telephone Number:
713-426-2400

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , 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: 0801771-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: DC1333 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 58JQ . This is a "BLUE CROSS BLUE SHIELD TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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