Provider Demographics
NPI:1831134329
Name:MEDICAL CHEST ASSOCIATES PA
Entity Type:Organization
Organization Name:MEDICAL CHEST ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:713-467-8888
Mailing Address - Street 1:902 FROSTWOOD DR STE 172
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2402
Mailing Address - Country:US
Mailing Address - Phone:713-467-8888
Mailing Address - Fax:713-467-5569
Practice Address - Street 1:902 FROSTWOOD
Practice Address - Street 2:SUITE 188
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2420
Practice Address - Country:US
Practice Address - Phone:713-467-8888
Practice Address - Fax:713-467-5569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083595101Medicaid