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General NPI Number Information
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NPI Number | 1730869207
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Entity Type | Organization
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Legal Business Name | ALTUS EXCEPTIONAL PHYSICIAN GROUP PLLC
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 1321 N 16TH ST
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City | ORANGE
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State | TX
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Zip | 77630-3609
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Country | US
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Telephone | 409-403-3309
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Fax |
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Provider Business Mailing Address
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Address Line | 1535 WEST LOOP S
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City | HOUSTON
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State | TX
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Zip | 77027-9512
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP REVENUE CYCLE
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Name | GALE JOHNSON
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Credential |
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Telephone | 832-219-3807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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