Provider Demographics
NPI:1497152268
Name:ROUND TABLE SPECIALIST GROUP, PLLC
Entity Type:Organization
Organization Name:ROUND TABLE SPECIALIST GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HASHIBUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-429-8027
Mailing Address - Street 1:8910 HIGHWAY 6 S
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-6339
Mailing Address - Country:US
Mailing Address - Phone:832-429-8027
Mailing Address - Fax:
Practice Address - Street 1:8910 HIGHWAY 6 S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-6339
Practice Address - Country:US
Practice Address - Phone:832-429-8027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-22
Last Update Date:2014-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty