Provider Demographics
NPI:1710306675
Name:HOUSTON NORTHWEST CANCER CENTER LP
Entity Type:Organization
Organization Name:HOUSTON NORTHWEST CANCER CENTER LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:KANADY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-364-1707
Mailing Address - Street 1:25511 BUDDE RD
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2080
Mailing Address - Country:US
Mailing Address - Phone:281-364-1707
Mailing Address - Fax:281-364-0028
Practice Address - Street 1:1140A CYPRESS STATION DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3058
Practice Address - Country:US
Practice Address - Phone:281-377-7555
Practice Address - Fax:281-364-0028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty