MEDICARE: NORTHWEST HYPERBARIC SPECIALISTS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1588846315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST HYPERBARIC SPECIALISTS PA

Provider Business Mailing Address
First Line	:	P.O. BOX 670626
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75267-0626
Country	:	US
Telephone Number	:	713-802-9024
Fax Number	:	713-802-1868

Provider Business Practice Location Address
First Line	:	1917 ASHLAND ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-3907
Country	:	US
Telephone Number	:	713-861-6161
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MR. ABDUL R ISHAQ
Credential	:
Telephone Number	:	832-876-6837

Provider Enumeration Date	:	12/04/2007
Last Update Date	:	01/16/2023

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