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NPI Code Detail

MEDICARE: EAST HOUSTON ORTHOPEDICS & SPORTS MEDICINE, P.A.

MEDICARE: EAST HOUSTON ORTHOPEDICS & SPORTS MEDICINE, P.A.
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
1174400000XSpecialistE8228TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CG3125OTHERTXMEDICARE RAILROAD
400R22HOTHERTXMEDICARE GROUP ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10897030001OTHERTXPALMETTO GBA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760488241
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAST HOUSTON ORTHOPEDICS & SPORTS MEDICINE, P.A.
Provider Business Mailing Address
First Line : 12930 EAST FWY
Second Line :
City : HOUSTON
State : TX
Zip : 77015-5710
Country : US
Telephone Number : 713-453-6909
Fax Number : 713-453-7627
Provider Business Practice Location Address
First Line : 12930 EAST FWY
Second Line :
City : HOUSTON
State : TX
Zip : 77015-5710
Country : US
Telephone Number : 713-453-6909
Fax Number : 713-453-7627
Authorized Official
Title or Position : PRESIDENT
Name : DR. BRUCE ROGER WEINER
Credential : M.D.
Telephone Number : 713-453-6909
Provider Enumeration Date : 06/21/2005
Last Update Date : 11/05/2007

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1306862230 — GARCIA & ASSOCIATES, EAST HOUSTON P.A.
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Directions to “EAST HOUSTON ORTHOPEDICS & SPORTS MEDICINE, P.A. ” Practice Location

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