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General NPI Number Information
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NPI Number | 1023291440
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Entity Type | Organization
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Legal Business Name | WEST HOUSTON OB/GYN ASSOCIATION
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 12121 RICHMOND AVE STE 117
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City | HOUSTON
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State | TX
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Zip | 77082-2466
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Country | US
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Telephone | 281-293-9988
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Fax | 281-293-8025
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Provider Business Mailing Address
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Address Line | 12121 RICHMOND AVE STE 117
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City | HOUSTON
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State | TX
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Zip | 77082-2466
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Country | US
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Telephone | 281-293-9988
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Fax | 281-293-8025
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BOUTROS A BOUTROS
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Credential | M.D.
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Telephone | 281-293-9988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | E7002
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License Number State | TX
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