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NPI Code Detail

MEDICARE: NIRP BRYAN-COLLEGE STATION PLLC

MEDICARE: NIRP BRYAN-COLLEGE STATION PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0204XVascular & Interventional Radiology Physician

General Provider Information

NPI Number : 1619432903
Entity Type Code : Organization
Provider Name (Legal Business Name) : NIRP BRYAN-COLLEGE STATION PLLC
Provider Business Mailing Address
First Line : 3730 KIRBY DR STE 1200
Second Line :
City : HOUSTON
State : TX
Zip : 77098-3985
Country : US
Telephone Number : 281-888-8999
Fax Number : 281-305-4054
Provider Business Practice Location Address
First Line : 3730 KIRBY DR STE 1200
Second Line :
City : HOUSTON
State : TX
Zip : 77098-3985
Country : US
Telephone Number : 281-888-8999
Fax Number : 281-305-4054
Authorized Official
Title or Position : CEO
Name : ANDREW E GOMES
Credential : MD
Telephone Number : 281-888-8999
Provider Enumeration Date : 01/31/2019
Last Update Date : 01/31/2019

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Directions to “NIRP BRYAN-COLLEGE STATION PLLC ” Practice Location

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