Organization
GREENWAY PLAZA ENT CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR FUSTOK (PRESIDEN/BUSINESS DEVELOPMENT)
(713) 621-2558
Entity
Organization
Contact information
Practice address
4140 SOUTHWEST FWY STE 510, HOUSTON, TX 77027-7319
(813) 621-2558
Mailing address
4140 SOUTHWEST FWY STE 510, HOUSTON, TX 77027-7319
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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