Provider Demographics
NPI:1023074077
Name:NORTHWEST MED CARE PA
Entity type:Organization
Organization Name:NORTHWEST MED CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YAMINI
Authorized Official - Middle Name:B
Authorized Official - Last Name:NAYGANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-890-2121
Mailing Address - Street 1:13325 HARGRAVE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4539
Mailing Address - Country:US
Mailing Address - Phone:281-890-2121
Mailing Address - Fax:281-890-5677
Practice Address - Street 1:13325 HARGRAVE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4539
Practice Address - Country:US
Practice Address - Phone:281-890-2121
Practice Address - Fax:281-890-5677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153873801Medicaid
TX153873801Medicaid