Provider Demographics
NPI:1669927752
Name:NORTH HOUSTON GYNECOLOGIC ONCOLOGY SURGEONS PLLC
Entity type:Organization
Organization Name:NORTH HOUSTON GYNECOLOGIC ONCOLOGY SURGEONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEFERTITI
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPONT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-292-1400
Mailing Address - Street 1:128 VISION PARK BLVD
Mailing Address - Street 2:280
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3017
Mailing Address - Country:US
Mailing Address - Phone:281-292-1400
Mailing Address - Fax:281-292-1404
Practice Address - Street 1:128 VISION PARK BLVD
Practice Address - Street 2:280
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3017
Practice Address - Country:US
Practice Address - Phone:281-292-1400
Practice Address - Fax:281-292-1404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207V00000X, 2086X0206X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty