Provider Demographics
NPI:1245354851
Name:PREMIER ONCOLOGY CONSULTANTS PA
Entity type:Organization
Organization Name:PREMIER ONCOLOGY CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-556-6622
Mailing Address - Street 1:9230 KATY FREEWAY
Mailing Address - Street 2:SUITE 410
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055
Mailing Address - Country:US
Mailing Address - Phone:281-556-6622
Mailing Address - Fax:281-556-6623
Practice Address - Street 1:9230 KATY FWY STE 410
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7468
Practice Address - Country:US
Practice Address - Phone:281-556-6622
Practice Address - Fax:281-556-6623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0508207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00800YMedicare ID - Type UnspecifiedGROUP ID