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General NPI Number Information
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NPI Number | 1902272289
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Entity Type | Organization
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Legal Business Name | HOUSTON CRANIOFACIAL AND SINUS SURGERY
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Dates
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Enumeration Date | 08/20/2015
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 6400 FANNIN ST 2290
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City | HOUSTON
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State | TX
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Zip | 77030-1521
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Country | US
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Telephone | 713-777-4687
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Fax | 281-768-8706
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Provider Business Mailing Address
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Address Line | 6400 FANNIN ST 2290
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City | HOUSTON
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State | TX
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Zip | 77030-1521
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Country | US
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Telephone | 713-777-4687
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Fax | 281-768-8706
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Authorized Official
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Title or Position | PATIENT CARE COORDINATOR
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Name | MRS. LAURIE ANN CARRAWAY
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Credential |
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Telephone | 713-777-4687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | M1087
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License Number State | TX
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