Healthcare Provider Details

I. General information

NPI: 1992842140
Provider Name (Legal Business Name): NORTHWEST HOUSTON SURGICAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 02/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21216 NORTHWEST FWY SUITE #250
CYPRESS TX
77429-1439
US

IV. Provider business mailing address

21216 NORTHWEST FWY SUITE #250
CYPRESS TX
77429-1439
US

V. Phone/Fax

Practice location:
  • Phone: 713-426-2400
  • Fax: 713-426-3204
Mailing address:
  • Phone: 713-426-2400
  • Fax: 713-426-3204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateTX

VIII. Authorized Official

Name: PAULETTE M CHARGOIS
Title or Position: ADMIN
Credential:
Phone: 713-426-2400