Provider Demographics
NPI:1245354851
Name:PREMIER ONCOLOGY CONSULTANTS PA
Entity type:Organization
Organization Name:PREMIER ONCOLOGY CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-556-6622
Mailing Address - Street 1:410 W GRAND PKWY S STE 4C
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-8361
Mailing Address - Country:US
Mailing Address - Phone:281-647-7766
Mailing Address - Fax:281-647-7767
Practice Address - Street 1:410 W GRAND PKWY S STE 4C
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8361
Practice Address - Country:US
Practice Address - Phone:281-647-7766
Practice Address - Fax:281-647-7767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0508207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00800YMedicare ID - Type UnspecifiedGROUP ID