Provider Demographics
NPI:1306880083
Name:LIVER ASSOCIATES OF TEXAS, P.A.
Entity type:Organization
Organization Name:LIVER ASSOCIATES OF TEXAS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ANKOMA-SEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-799-8300
Mailing Address - Street 1:PO BOX 300928
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77230-0928
Mailing Address - Country:US
Mailing Address - Phone:713-799-8300
Mailing Address - Fax:713-799-8305
Practice Address - Street 1:6560 FANNIN ST STE 1980
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2710
Practice Address - Country:US
Practice Address - Phone:713-799-8300
Practice Address - Fax:713-799-8305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1344174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175636301Medicaid