Provider Demographics
NPI:1932468402
Name:HOUSTON NW ID SPECIALISTS PA
Entity Type:Organization
Organization Name:HOUSTON NW ID SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJENDRA
Authorized Official - Middle Name:G
Authorized Official - Last Name:PANDYA
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:713-464-7555
Mailing Address - Street 1:12025 LOUETTA RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-1149
Mailing Address - Country:US
Mailing Address - Phone:281-251-7888
Mailing Address - Fax:281-251-4222
Practice Address - Street 1:12025 LOUETTA RD
Practice Address - Street 2:SUITE D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1149
Practice Address - Country:US
Practice Address - Phone:281-251-7888
Practice Address - Fax:281-251-4222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty