Provider Demographics
NPI:1629279062
Name:LONG POINT MD.PA.
Entity Type:Organization
Organization Name:LONG POINT MD.PA.
Other - Org Name:LONG POINT MD.PA.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-722-8799
Mailing Address - Street 1:8153 LONG POINT RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-2032
Mailing Address - Country:US
Mailing Address - Phone:713-722-8799
Mailing Address - Fax:713-722-8830
Practice Address - Street 1:8153 LONG POINT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-2032
Practice Address - Country:US
Practice Address - Phone:713-722-8799
Practice Address - Fax:713-722-8830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBJ7030OtherBLUECROSS
TXD4359OtherSTATE LICENSE
TX00940VOtherMEDICARE GROUP
TX00940VMedicare ID - Type Unspecified
TXBJ7030OtherBLUECROSS