Basic Information
| Provider Information | |||||||||
| NPI: | 1083916548 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH HOUSTON ENDOSCOPY, P.A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3079 PEACHTREE INDUSTRIAL BLVD | ||||||||
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| City: | DULUTH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300972215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709455330 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1140 CYPRESS STATION DR | ||||||||
| Address2: | #306 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770903045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814403618 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2010 | ||||||||
| LastUpdateDate: | 12/03/2010 | ||||||||
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| AuthorizedOfficialLastName: | WINSTON | ||||||||
| AuthorizedOfficialFirstName: | BARRY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2814403618 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.