Provider Demographics
NPI:1326161746
Name:JOEL E NACHIMSON MD PA
Entity Type:Organization
Organization Name:JOEL E NACHIMSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:NACHIMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-440-1632
Mailing Address - Street 1:800 PEAKWOOD DR STE 7J
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2904
Mailing Address - Country:US
Mailing Address - Phone:281-440-1632
Mailing Address - Fax:
Practice Address - Street 1:800 PEAKWOOD DR STE 7J
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2904
Practice Address - Country:US
Practice Address - Phone:281-440-1632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4571207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170665701Medicaid
TX00405TMedicare ID - Type UnspecifiedMEDICARE