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ROGER C WILLETTE MD; PA NPI 1679734628


NPI Information

NPI: 1679734628
Provider Name: ROGER C WILLETTE MD; PA

Doing Business As: ROGER C WILLETTE MD; PA

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1322 SPACE PARK DR
STE B150
HOUSTON, TX
ZIP 77058
Phone: (281) 333-1213
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ROGER C WILLETTE MD; PA is a specialist in Houston, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ROGER C WILLETTE MD; PA NPI is 1679734628. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Roger C Willette Md; Pa.

The provider's business location address is:

1322 SPACE PARK DR
STE B150
HOUSTON, TX
ZIP 77058-400
Phone: (281) 333-1213
Fax: (281) 333-9573

The provider's authorized official is Carey Kneupper .
The authorized official title is Practice Administrator and has the following contact phone number (281) 333-1213.

The enumeration date for this NPI number is 6/23/2008 and was last updated on 7/8/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistG6771TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C23504MEDICARE UPINTEXAS
2097810801MEDICAIDTEXAS
300D01FMEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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