Provider Demographics
NPI:1952529802
Name:NORTHWEST ENT SURGICAL ASSOICATES, P.A.
Entity Type:Organization
Organization Name:NORTHWEST ENT SURGICAL ASSOICATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCUTCHEON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-802-9779
Mailing Address - Street 1:1740 W 27TH STREET
Mailing Address - Street 2:SUITE 234
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008
Mailing Address - Country:US
Mailing Address - Phone:713-802-9779
Mailing Address - Fax:713-802-2289
Practice Address - Street 1:9180 OLD KATY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055
Practice Address - Country:US
Practice Address - Phone:713-647-7700
Practice Address - Fax:713-647-8090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical