Healthcare Provider Details

I. General information

NPI: 1255537601
Provider Name (Legal Business Name): WEST HOUSTON OB GYN PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12121 RICHMOND AVE STE 215
HOUSTON TX
77082-2422
US

IV. Provider business mailing address

12121 RICHMOND AVE STE 215
HOUSTON TX
77082-2422
US

V. Phone/Fax

Practice location:
  • Phone: 281-558-2737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberF6835
License Number StateTX

VIII. Authorized Official

Name: DR. MATTI KORHONEN
Title or Position: PRESIDENT
Credential: M.D., PH.D.
Phone: 281-558-2737