Provider Demographics
NPI:1558000836
Name:INFECTIOUS DISEASES CONSULTANTS OF NORTHWEST HOUSTON PLLC
Entity Type:Organization
Organization Name:INFECTIOUS DISEASES CONSULTANTS OF NORTHWEST HOUSTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:PANKOW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-775-8914
Mailing Address - Street 1:10703 WINDING ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7136
Mailing Address - Country:US
Mailing Address - Phone:713-775-8914
Mailing Address - Fax:832-308-1272
Practice Address - Street 1:13656 BRETON RIDGE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-6081
Practice Address - Country:US
Practice Address - Phone:713-464-7555
Practice Address - Fax:832-308-1272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty