Basic Information
| Provider Information | |||||||||
| NPI: | 1619574548 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EVEREST MULTI SPECIALITY GROUP LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2245 TEXAS DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774791468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322861108 | ||||||||
| FaxNumber: | 8323081272 | ||||||||
| Practice Location | |||||||||
| Address1: | 2245 TEXAS DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774791468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322861108 | ||||||||
| FaxNumber: | 8323081272 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2020 | ||||||||
| LastUpdateDate: | 10/05/2020 | ||||||||
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| AuthorizedOfficialLastName: | KHAN | ||||||||
| AuthorizedOfficialFirstName: | SOHAIL | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8322861108 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MANAGER | ||||||||
| NPICertificationDate: | 10/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.