=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730477035
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RESPIRATORY MEDICINE CONSULTANTS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2011
-----------------------------------------------------
Last Update Date | 04/29/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1220 BLALOCK RD STE 250
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77055-6473
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-932-8664
-----------------------------------------------------
Fax | 713-464-2976
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9337B KATY FWY STE 267
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77024-1515
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-932-8664
-----------------------------------------------------
Fax | 713-464-2976
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER/PRESIDENT
-----------------------------------------------------
Name | DR. LESLIE M. HABER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 713-932-8664
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------