Provider Demographics
NPI:1629658711
Name:RHEUMATOLOGY ASSOCIATES OF GREATER HOUSTON PLLC
Entity Type:Organization
Organization Name:RHEUMATOLOGY ASSOCIATES OF GREATER HOUSTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAWARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-227-3403
Mailing Address - Street 1:11569 S HIGHWAY 6
Mailing Address - Street 2:PMB 197
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-4932
Mailing Address - Country:US
Mailing Address - Phone:281-652-5943
Mailing Address - Fax:281-652-5944
Practice Address - Street 1:777 S FRY RD STE 102
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2297
Practice Address - Country:US
Practice Address - Phone:281-652-5943
Practice Address - Fax:281-652-5944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1W6870OtherMEDICARE
TX431613501Medicaid