MEDICARE: DR. HOMERO RENE ANCHONDO MD PA

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
1	207T00000X	Neurological Surgery Physician	E7361	TX

General Provider Information

NPI Number	:	1649261355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOMERO RENE ANCHONDO MD PA

Provider Business Mailing Address
First Line	:	3607 KINGSTON VALE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-5037
Country	:	US
Telephone Number	:	281-787-2754
Fax Number	:	281-870-1533

Provider Business Practice Location Address
First Line	:	3607 KINGSTON VALE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-5037
Country	:	US
Telephone Number	:	281-787-2754
Fax Number	:	281-870-1533

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/08/2007

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