Provider Demographics
NPI:1134288921
Name:ATANASOV, STRAHIL T (MD)
Entity Type:Individual
Prefix:
First Name:STRAHIL
Middle Name:T
Last Name:ATANASOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58713
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77258-8713
Mailing Address - Country:US
Mailing Address - Phone:281-316-8400
Mailing Address - Fax:281-316-8410
Practice Address - Street 1:13455 CUTTEN RD STE 2K
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-1486
Practice Address - Country:US
Practice Address - Phone:832-232-0030
Practice Address - Fax:832-232-0031
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9958207RS0012X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124723107Medicaid
TX124723104Medicaid
TX8CK202OtherBCBSTX
TXP01060249OtherRRMEDICARE
TX8CK202OtherBCBSTX
TX8CK202OtherBCBSTX
TX8815J3Medicare ID - Type Unspecified
TX760010407OtherEIN
TXTXB105412Medicare PIN
TX124723104Medicaid
TXCI5830Medicare PIN
TX00R518Medicare PIN
TX00112RMedicare PIN