Healthcare Provider Details

I. General information

NPI: 1184778979
Provider Name (Legal Business Name): RIVER OAKS NEUROLOGY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4126 SOUTHWEST FWY 1130
HOUSTON TX
77027-7310
US

IV. Provider business mailing address

PO BOX 540088
HOUSTON TX
77254-0088
US

V. Phone/Fax

Practice location:
  • Phone: 713-960-9700
  • Fax:
Mailing address:
  • Phone: 713-850-1190
  • Fax: 713-850-1327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: GAVIN NORRIS
Title or Position: DIRECTOR
Credential: MD
Phone: 713-960-9700