Provider Demographics
NPI:1073665329
Name:EMWIL MEDICAL ASSOCIATES PA
Entity Type:Organization
Organization Name:EMWIL MEDICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOE
Authorized Official - Middle Name:OO
Authorized Official - Last Name:ZAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-773-1132
Mailing Address - Street 1:PO BOX 741184
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77274-1184
Mailing Address - Country:US
Mailing Address - Phone:713-773-1132
Mailing Address - Fax:713-773-3866
Practice Address - Street 1:6065 HILLCROFT ST STE 208
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-1005
Practice Address - Country:US
Practice Address - Phone:713-773-1132
Practice Address - Fax:713-773-3866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6431207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143485401Medicaid
G74387Medicare UPIN
00444RMedicare ID - Type Unspecified