Organization
EAST HOUSTON ORTHOPEDICS & SPORTS MEDICINE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ROGER WEINER M.D. (PRESIDENT)
(713) 453-6909
Entity
Organization
Contact information
Practice address
12930 EAST FWY, HOUSTON, TX 77015-5710
(713) 453-6909
(713) 453-7627
Mailing address
12930 EAST FWY, HOUSTON, TX 77015-5710
(713) 453-6909
(713) 453-7627
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E8228
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00R22H
MEDICARE GROUP ID
TX
05
—
084705501
—
TX
01
—
0897030001
PALMETTO GBA
TX
01
—
CG3125
MEDICARE RAILROAD
TX
Enumeration date
06/21/2005
Last updated
11/05/2007
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