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General NPI Number Information
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NPI Number | 1013930973
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Entity Type | Organization
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Legal Business Name | HUMBLE EMERGENCY PHYSICAINS PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 09/06/2007
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Provider Practice Location Address
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Address Line | 18951 N MEMORIAL DR
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City | HUMBLE
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State | TX
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Zip | 77338-4217
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Country | US
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Telephone | 281-540-6453
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Fax | 281-540-7393
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Provider Business Mailing Address
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Address Line | 18951 N MEMORIAL DR
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City | HUMBLE
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State | TX
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Zip | 77338-4217
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Country | US
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Telephone | 281-540-6453
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Fax | 281-540-7393
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID W. OLSON
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Credential | M.D.
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Telephone | 281-540-6453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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