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General NPI Number Information
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NPI Number | 1447258520
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Entity Type | Organization
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Legal Business Name | HOUSTON NORTHWEST RADIOTHERAPY CENTER
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 810 PEAKWOOD DR SUITE D
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City | HOUSTON
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State | TX
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Zip | 77090-2921
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Country | US
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Telephone | 281-893-3273
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Fax | 281-893-3683
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Provider Business Mailing Address
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Address Line | 810 PEAKWOOD DR SUITE D
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City | HOUSTON
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State | TX
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Zip | 77090-2921
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Country | US
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Telephone | 281-893-3273
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Fax | 281-893-3683
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. CYNTHIA DAVILA-PRUNEDA
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Credential |
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Telephone | 281-579-0061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number | L02416
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License Number State | TX
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