Provider Demographics
NPI:1417056474
Name:NORTHWEST HOUSTON ANESTHESIA, P.A.
Entity Type:Organization
Organization Name:NORTHWEST HOUSTON ANESTHESIA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAKA
Authorized Official - Middle Name:C
Authorized Official - Last Name:GOHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-351-3830
Mailing Address - Street 1:425 HOLDERRIETH SUITE 211
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4552
Mailing Address - Country:US
Mailing Address - Phone:281-351-3830
Mailing Address - Fax:281-351-6275
Practice Address - Street 1:425 HOLDERRIETH BLVD STE 211
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4552
Practice Address - Country:US
Practice Address - Phone:281-351-3830
Practice Address - Fax:281-351-6275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y009Medicare PIN