Provider Demographics
NPI:1750480620
Name:NORTHWEST HOUSTON HAND CENTER PA
Entity Type:Organization
Organization Name:NORTHWEST HOUSTON HAND CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:ALPHONES
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-812-1612
Mailing Address - Street 1:PO BOX 73547
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77273-3547
Mailing Address - Country:US
Mailing Address - Phone:713-812-1615
Mailing Address - Fax:281-537-7371
Practice Address - Street 1:3726 DACOMA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-8906
Practice Address - Country:US
Practice Address - Phone:713-812-1612
Practice Address - Fax:713-537-7371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0474207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0085MLOtherBC BS GROUP NUMBER
TX0085MLOtherBC BS GROUP NUMBER
TX=========OtherTRICARE NUMBER