Provider Demographics
NPI:1083727226
Name:NORTHWEST ORTHOPEDIC ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:NORTHWEST ORTHOPEDIC ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-864-2663
Mailing Address - Street 1:1919 NORTH LOOP W STE 115
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1392
Mailing Address - Country:US
Mailing Address - Phone:713-864-2663
Mailing Address - Fax:713-802-0684
Practice Address - Street 1:1919 NORTH LOOP W STE 115
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1392
Practice Address - Country:US
Practice Address - Phone:713-864-2663
Practice Address - Fax:713-802-0684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114771201Medicaid