Provider Demographics
NPI:1396882692
Name:LARRY L LIKOVER MD PA
Entity type:Organization
Organization Name:LARRY L LIKOVER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LIKOVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-465-0696
Mailing Address - Street 1:909 FROSTWOOD
Mailing Address - Street 2:#353
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:713-465-0696
Mailing Address - Fax:713-465-7334
Practice Address - Street 1:909 FROSTWOOD
Practice Address - Street 2:#353
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:713-465-0696
Practice Address - Fax:713-465-7334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4483207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00886NMedicare ID - Type Unspecified
B24396Medicare UPIN