Provider Demographics
NPI:1194295030
Name:WESTHEIMER MEDICAL GROUP PLLC
Entity type:Organization
Organization Name:WESTHEIMER MEDICAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLA
Authorized Official - Middle Name:ABIOLA
Authorized Official - Last Name:AJAYI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-360-6336
Mailing Address - Street 1:5433 WESTHEIMER RD STE 275
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-5331
Mailing Address - Country:US
Mailing Address - Phone:713-360-6336
Mailing Address - Fax:713-360-6514
Practice Address - Street 1:5433 WESTHEIMER RD STE 275
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5331
Practice Address - Country:US
Practice Address - Phone:713-360-6336
Practice Address - Fax:713-360-6514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty