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Organization

MEMORIAL NW OTOLARYNGOLOGY HEAD & NECK SURGERY ASSOCIATES

Active
Other names
Memorial Village Sinus and Hearing, Memorial Village ENT
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CONRAD KYLE MCCUTCHEON M.D. (OWNER)
(281) 822-3777
Entity
Organization

Contact information

Practice address
9055 KATY FWY, SUITE 415, HOUSTON, TX 77024-1624
(281) 822-3777
(281) 822-3776
Mailing address
9055 KATY FWY, SUITE 415, HOUSTON, TX 77024-1624
(281) 822-3777
(281) 822-3776

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00575U
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/24/2006
Last updated
11/03/2021
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