Provider Demographics
NPI:1992842140
Name:NORTHWEST HOUSTON SURGICAL ASSOCIATION
Entity Type:Organization
Organization Name:NORTHWEST HOUSTON SURGICAL ASSOCIATION
Other - Org Name:NHSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHARGOIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-426-2400
Mailing Address - Street 1:21216 NORTHWEST FWY
Mailing Address - Street 2:SUITE #250
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-1439
Mailing Address - Country:US
Mailing Address - Phone:713-426-2400
Mailing Address - Fax:713-426-3204
Practice Address - Street 1:21216 NORTHWEST FWY
Practice Address - Street 2:SUITE #250
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1439
Practice Address - Country:US
Practice Address - Phone:713-426-2400
Practice Address - Fax:713-426-3204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0801771-01Medicaid
TXDC1333OtherMEDICARE RAILROAD
TX58JQOtherBLUE CROSS BLUE SHIELD TEXAS
TXDC1333OtherMEDICARE RAILROAD