Healthcare Provider Details

I. General information

NPI: 1215235155
Provider Name (Legal Business Name): NORTHWEST PULMONARY CRITICAL CARE AND SLEEP SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W 26TH ST STE 200
HOUSTON TX
77008-1452
US

IV. Provider business mailing address

1800 W 26TH ST STE 200
HOUSTON TX
77008-1452
US

V. Phone/Fax

Practice location:
  • Phone: 281-652-5864
  • Fax: 832-529-6463
Mailing address:
  • Phone: 281-652-5864
  • Fax: 832-529-6463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberN 4033
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberN 4033
License Number StateTX

VIII. Authorized Official

Name: RAJESH RETHNAM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 713-657-5131