Basic Information
Provider Information
NPI: 1518120575
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROWE
FirstName: ANTHONY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7026 OLD KATY RD
Address2: STE 276
City: HOUSTON
State: TX
PostalCode: 770242187
CountryCode: US
TelephoneNumber: 7136217436
FaxNumber: 7139639051
Practice Location
Address1: 7026 OLD KATY RD
Address2: SUITE 276
City: HOUSTON
State: TX
PostalCode: 770242137
CountryCode: US
TelephoneNumber: 7136217436
FaxNumber: 7139639051
Other Information
ProviderEnumerationDate: 07/09/2008
LastUpdateDate: 03/08/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XQ7459TXY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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