MEDICARE: TRIUMPH HYPERBARIC P.A.

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	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician

General Provider Information

NPI Number	:	1720110992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIUMPH HYPERBARIC P.A.

Provider Business Mailing Address
First Line	:	7333 NORTH FWY STE 310
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-1320
Country	:	US
Telephone Number	:	713-464-7555
Fax Number	:	713-464-0219

Provider Business Practice Location Address
First Line	:	7333 NORTH FWY STE 310
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-1320
Country	:	US
Telephone Number	:	713-464-7555
Fax Number	:	713-464-0219

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. SANDRA J WILLIAMS
Credential	:
Telephone Number	:	713-464-7555

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	10/03/2007

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