Provider Demographics
NPI:1558801506
Name:BREAST HEALTH INSTITUTION OF HOUSTON
Entity Type:Organization
Organization Name:BREAST HEALTH INSTITUTION OF HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILTENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-908-6485
Mailing Address - Street 1:7400 FANNIN ST # 700C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7400 FANNIN ST # 700C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1920
Practice Address - Country:US
Practice Address - Phone:713-795-1016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty