Healthcare Provider Details

I. General information

NPI: 1568769248
Provider Name (Legal Business Name): RHEUMATOLOGY CENTER OF HOUSTON, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2011
Last Update Date: 03/16/2025
Certification Date: 03/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 AUSTIN ST STE 200
HOUSTON TX
77002-8912
US

IV. Provider business mailing address

2204 AUSTIN ST STE 200
HOUSTON TX
77002-8912
US

V. Phone/Fax

Practice location:
  • Phone: 713-640-5477
  • Fax: 712-640-5872
Mailing address:
  • Phone: 713-640-5477
  • Fax: 713-640-5872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberM2179
License Number StateTX

VIII. Authorized Official

Name: JACQUELINE VO
Title or Position: AGENT
Credential: MD
Phone: 713-640-5477