Provider Demographics
NPI:1417043324
Name:NORTHWEST HOUSTON HEART CENTER P.A.
Entity Type:Organization
Organization Name:NORTHWEST HOUSTON HEART CENTER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OFFICE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-351-4911
Mailing Address - Street 1:PO BOX 732672
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-4869
Mailing Address - Country:US
Mailing Address - Phone:281-351-4911
Mailing Address - Fax:281-351-4915
Practice Address - Street 1:308 HOLDERRIETH BLVD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4536
Practice Address - Country:US
Practice Address - Phone:281-351-4911
Practice Address - Fax:281-351-4915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00727ZMedicare PIN