Provider Demographics
NPI:1275608788
Name:PARK PLAZA ORTHOPEDIC ASSOCIATES
Entity Type:Organization
Organization Name:PARK PLAZA ORTHOPEDIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-526-9986
Mailing Address - Street 1:1200 BINZ SUITE 1430
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004
Mailing Address - Country:US
Mailing Address - Phone:713-526-9986
Mailing Address - Fax:713-522-5200
Practice Address - Street 1:1200 BINZ SUITE 1430
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004
Practice Address - Country:US
Practice Address - Phone:713-526-9986
Practice Address - Fax:713-522-5200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDA3051OtherRAILROAD MEDICARE
0021KGOtherBCBS
TX159426901Medicaid
TXDA3051OtherRAILROAD MEDICARE
TX0816200001Medicare NSC