Organization
HOUSTON NORTHWEST RADIOTHERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA DAVILA-PRUNEDA (MANAGER)
(281) 579-0061
Entity
Organization
Contact information
Practice address
810 PEAKWOOD DR, SUITE D, HOUSTON, TX 77090-2921
(281) 893-3273
(281) 893-3683
Mailing address
810 PEAKWOOD DR, SUITE D, HOUSTON, TX 77090-2921
(281) 893-3273
(281) 893-3683
Taxonomy
Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
L02416
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00DT11
BLUE CROSS
TX
05
—
160339101
—
TX
Enumeration date
07/12/2005
Last updated
08/11/2009
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