Provider Demographics
NPI:1316204563
Name:PERAMID MEDICAL CENTER INC
Entity type:Organization
Organization Name:PERAMID MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIYAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TOKTAROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-537-1154
Mailing Address - Street 1:5959 WESTHEIMER RD STE 207
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7613
Mailing Address - Country:US
Mailing Address - Phone:713-537-1154
Mailing Address - Fax:
Practice Address - Street 1:5959 WESTHEIMER RD STE 207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7613
Practice Address - Country:US
Practice Address - Phone:713-537-1154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty