Provider Demographics
NPI:1740384908
Name:PLAZA OB-GYN ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:PLAZA OB-GYN ASSOCIATES, PLLC
Other - Org Name:PLAZA OB-GYN ASSOCIATES, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-522-3333
Mailing Address - Street 1:1801 BINZ STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004
Mailing Address - Country:US
Mailing Address - Phone:713-522-3333
Mailing Address - Fax:713-522-4434
Practice Address - Street 1:1801 BINZ STREET
Practice Address - Street 2:SUITE 500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004
Practice Address - Country:US
Practice Address - Phone:713-522-3333
Practice Address - Fax:713-522-4434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0795207V00000X
TX207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80215901Medicaid
TX080215901Medicaid
TX80215901Medicaid