Healthcare Provider Details
I. General information
NPI: 1225148778
Provider Name (Legal Business Name): NORTH HOUSTON PHYSICIANS P A
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
509 W TIDWELL RD STE 200
HOUSTON TX
77091-4356
US
IV. Provider business mailing address
PO BOX 11076
SPRING TX
77391-1076
US
V. Phone/Fax
- Phone: 713-691-7490
- Fax: 713-691-0079
- Phone: 713-691-7490
- Fax: 713-691-0079
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CARLOS
J
PALACIOS
Title or Position: OWNER
Credential: MD
Phone: 832-247-8509