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General NPI Number Information
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NPI Number | 1295733327
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Entity Type | Organization
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Legal Business Name | NORTHWEST RADIOTHERAPY ASSOCIATION
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 08/31/2012
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Provider Practice Location Address
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Address Line | 13700 MEDICAL COMPLEX DR
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City | TOMBALL
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State | TX
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Zip | 77375-6554
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Country | US
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Telephone | 713-467-5700
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Fax | 713-467-5702
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Provider Business Mailing Address
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Address Line | PO BOX 73152
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City | HOUSTON
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State | TX
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Zip | 77273-3152
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Country | US
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Telephone | 713-467-5700
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Fax | 713-467-5702
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Authorized Official
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Title or Position | MANAGER
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Name | CYNTHIA DAVILA-PRUNEDA
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Credential |
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Telephone | 713-467-5700
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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 |
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License Number State |
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