Provider Demographics
NPI:1225563414
Name:EXTREMITY HEALTHCARE INC
Entity Type:Organization
Organization Name:EXTREMITY HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BAHER
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAXIMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-598-6040
Mailing Address - Street 1:810 WAUGH DR
Mailing Address - Street 2:STE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-2000
Mailing Address - Country:US
Mailing Address - Phone:713-522-5111
Mailing Address - Fax:
Practice Address - Street 1:810 WAUGH DR
Practice Address - Street 2:STE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-2000
Practice Address - Country:US
Practice Address - Phone:713-522-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6486207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty