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NPI Code Detail

MEDICARE: NORTHWEST HOUSTON HAND CENTER PA

MEDICARE: NORTHWEST HOUSTON HAND CENTER 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
1207XS0106XOrthopaedic Hand Surgery PhysicianM0474TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10085MLOTHERTXBC BS GROUP NUMBER

General Provider Information

NPI Number : 1750480620
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHWEST HOUSTON HAND CENTER PA
Provider Business Mailing Address
First Line : PO BOX 73547
Second Line :
City : HOUSTON
State : TX
Zip : 77273-3547
Country : US
Telephone Number : 713-812-1615
Fax Number : 281-537-7371
Provider Business Practice Location Address
First Line : 3726 DACOMA ST
Second Line :
City : HOUSTON
State : TX
Zip : 77092-8906
Country : US
Telephone Number : 713-812-1612
Fax Number : 713-537-7371
Authorized Official
Title or Position : MEDICAL DIRECTOR SURGEON
Name : RANDOLPH ALPHONES LOPEZ
Credential : MD
Telephone Number : 713-812-1612
Provider Enumeration Date : 09/21/2006
Last Update Date : 08/22/2020

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Directions to “NORTHWEST HOUSTON HAND CENTER PA ” Practice Location

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