Provider Demographics
NPI:1902272289
Name:HOUSTON CRANIOFACIAL AND SINUS SURGERY
Entity Type:Organization
Organization Name:HOUSTON CRANIOFACIAL AND SINUS SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT CARE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CARRAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-777-4687
Mailing Address - Street 1:6400 FANNIN ST
Mailing Address - Street 2:2290
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1521
Mailing Address - Country:US
Mailing Address - Phone:713-777-4687
Mailing Address - Fax:281-768-8706
Practice Address - Street 1:6400 FANNIN ST
Practice Address - Street 2:2290
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1521
Practice Address - Country:US
Practice Address - Phone:713-777-4687
Practice Address - Fax:281-768-8706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1087207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty