Provider Demographics
NPI:1447372123
Name:PEDIATRIC HEALTHCARE OF NORTHWEST HOUSTON PA
Entity type:Organization
Organization Name:PEDIATRIC HEALTHCARE OF NORTHWEST HOUSTON PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KHOZEMA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PALANPURWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-357-5115
Mailing Address - Street 1:11840 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3840
Mailing Address - Country:US
Mailing Address - Phone:832-912-7044
Mailing Address - Fax:832-912-7033
Practice Address - Street 1:12015 LOUETTA RD STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1148
Practice Address - Country:US
Practice Address - Phone:281-664-2152
Practice Address - Fax:281-257-3514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8338208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035826904Medicaid
TX1134124779OtherNPI
1346554086OtherNPI
1275835530OtherNPI
TX1346247301OtherNPI
1922115534OtherNPI
TX039452004Medicaid
1508848995OtherNPI
1841389897OtherNPI
TX128256808Medicaid
1295737286OtherNPI
1780651133OtherNPI
TX160185803Medicaid
TX218384001Medicaid
TX1841389897OtherNPI
TX194471202Medicaid
1992772990OtherNPI
TX130902308Medicaid
1386611721OtherNPI