Provider Demographics
NPI:1134232002
Name:CHANNELVIEW MEDICAL CENTER INC
Entity type:Organization
Organization Name:CHANNELVIEW MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-652-0011
Mailing Address - Street 1:11929 I-10 EAST FWY
Mailing Address - Street 2:STE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-2025
Mailing Address - Country:US
Mailing Address - Phone:713-451-2100
Mailing Address - Fax:713-451-2101
Practice Address - Street 1:11929 I-10 EAST FWY
Practice Address - Street 2:STE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-2025
Practice Address - Country:US
Practice Address - Phone:713-451-2100
Practice Address - Fax:713-451-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9768111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty