Basic Information
| Provider Information | |||||||||
| NPI: | 1679864607 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREATER EXPERT MEDICAL PHYSICIANS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 BAGBY ST | ||||||||
| Address2: | #13430 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770028587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9035312371 | ||||||||
| FaxNumber: | 9035312337 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 BAGBY ST | ||||||||
| Address2: | #13430 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770028587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9035312371 | ||||||||
| FaxNumber: | 9035312337 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2011 | ||||||||
| LastUpdateDate: | 04/25/2011 | ||||||||
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| AuthorizedOfficialLastName: | PHAN | ||||||||
| AuthorizedOfficialFirstName: | CUONG | ||||||||
| AuthorizedOfficialMiddleName: | Q | ||||||||
| AuthorizedOfficialTitleorPosition: | SOLE OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9035312371 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.