Provider Demographics
NPI:1538197215
Name:OB GYN OF HOUSTON, LLP
Entity type:Organization
Organization Name:OB GYN OF HOUSTON, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:MUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-796-8334
Mailing Address - Street 1:6410 FANNIN ST
Mailing Address - Street 2:#200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3000
Mailing Address - Country:US
Mailing Address - Phone:713-796-8334
Mailing Address - Fax:713-799-2708
Practice Address - Street 1:6410 FANNIN ST
Practice Address - Street 2:#200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3000
Practice Address - Country:US
Practice Address - Phone:713-796-8334
Practice Address - Fax:713-799-2708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9213174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164738001Medicaid
TX164738001Medicaid
TXE68210Medicare UPIN