Healthcare Provider Details

I. General information

NPI: 1639477748
Provider Name (Legal Business Name): BAY AREA INTEGRATED SOLUTIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2011
Last Update Date: 03/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18333 EGRET BAY BLVD SUITE 200
HOUSTON TX
77058-3860
US

IV. Provider business mailing address

18333 EGRET BAY BLVD SUITE 200
HOUSTON TX
77058-3860
US

V. Phone/Fax

Practice location:
  • Phone: 281-333-1300
  • Fax: 281-333-1303
Mailing address:
  • Phone: 281-333-1300
  • Fax: 281-333-1303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberJ8168
License Number StateTX

VIII. Authorized Official

Name: RICHARD M WESTMARK
Title or Position: MANAGER
Credential: MD
Phone: 281-333-1300