Provider Demographics
NPI:1609053453
Name:RUTEK CENTER FOR REPRODUCTIVE MEDICINE PA
Entity type:Organization
Organization Name:RUTEK CENTER FOR REPRODUCTIVE MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:ZOMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-530-4587
Mailing Address - Street 1:PO BOX 57908
Mailing Address - Street 2:250 BLOSSOM STREET SUITE #120
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:281-724-0260
Mailing Address - Fax:281-724-0262
Practice Address - Street 1:250 BLOSSOM STREET
Practice Address - Street 2:SUITE #120
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598
Practice Address - Country:US
Practice Address - Phone:281-724-0260
Practice Address - Fax:281-724-0262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7273207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty