Provider Demographics
NPI:1609087006
Name:ROC-HOUSTON, P.A.
Entity Type:Organization
Organization Name:ROC-HOUSTON, P.A.
Other - Org Name:RECONSTRUCTIVE ORTHOPAEDIC CENTER OF HOUSTON, PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:V
Authorized Official - Last Name:MASSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-953-8321
Mailing Address - Street 1:1200 BINZ ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6944
Mailing Address - Country:US
Mailing Address - Phone:281-953-8321
Mailing Address - Fax:
Practice Address - Street 1:1213 HERMANN DR STE 380
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7086
Practice Address - Country:US
Practice Address - Phone:281-953-8321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1304332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5080910001Medicare ID - Type UnspecifiedDME -SUPPLIER #