Provider Demographics
NPI:1467802223
Name:NORTHWEST HOUSTON MEDICAL CENTER
Entity Type:Organization
Organization Name:NORTHWEST HOUSTON MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:331-305-2813
Mailing Address - Street 1:11240 FM 1960 RD W
Mailing Address - Street 2:406
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3662
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 JORIE BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-2214
Practice Address - Country:US
Practice Address - Phone:331-305-2813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty