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General NPI Number Information
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NPI Number | 1245895333
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Entity Type | Organization
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Legal Business Name | PREMIER HOSPITALIST GROUP PLLC
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Dates
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Enumeration Date | 05/05/2019
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Last Update Date | 05/05/2019
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Provider Practice Location Address
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Address Line | 22999 HIGHWAY 59 N
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City | KINGWOOD
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State | TX
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Zip | 77339-4412
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Country | US
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Telephone | 936-443-7408
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Fax |
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Provider Business Mailing Address
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Address Line | 16709 HIGHLINE BLVD
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City | CONROE
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State | TX
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Zip | 77306-6045
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Country | US
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Telephone | 936-443-7808
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Fax |
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Authorized Official
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Title or Position | BILLING
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Name | KHUZEMA KANCHWALA
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Credential |
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Telephone | 281-467-1114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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