Provider Demographics
NPI:1831513860
Name:PATCH TESTING CENTER OF EXCELLENCE-HOUSTON
Entity type:Organization
Organization Name:PATCH TESTING CENTER OF EXCELLENCE-HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-558-3376
Mailing Address - Street 1:12606 W HOUSTON CENTER BLVD
Mailing Address - Street 2:SUITE# 230
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2784
Mailing Address - Country:US
Mailing Address - Phone:281-558-3376
Mailing Address - Fax:281-558-0544
Practice Address - Street 1:12606 W HOUSTON CENTER BLVD
Practice Address - Street 2:SUITE# 230
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2784
Practice Address - Country:US
Practice Address - Phone:281-558-3376
Practice Address - Fax:281-558-0544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6399174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty