Healthcare Provider Details

I. General information

NPI: 1609053453
Provider Name (Legal Business Name): RUTEK CENTER FOR REPRODUCTIVE MEDICINE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BLOSSOM STREET SUITE #120
WEBSTER TX
77598
US

IV. Provider business mailing address

PO BOX 57908 250 BLOSSOM STREET SUITE #120
WEBSTER TX
77598
US

V. Phone/Fax

Practice location:
  • Phone: 281-724-0260
  • Fax: 281-724-0262
Mailing address:
  • Phone: 281-724-0260
  • Fax: 281-724-0262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberL7273
License Number StateTX

VIII. Authorized Official

Name: WILLIE D ZOMA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 713-530-4587