Provider Demographics
NPI:1699471383
Name:HOUSTON PHYSICIAN SPECIALISTS, LLC
Entity type:Organization
Organization Name:HOUSTON PHYSICIAN SPECIALISTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:WHILDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-542-7959
Mailing Address - Street 1:1601 WATSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3431
Mailing Address - Country:US
Mailing Address - Phone:478-352-4304
Mailing Address - Fax:
Practice Address - Street 1:1601 WATSON BLVD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3431
Practice Address - Country:US
Practice Address - Phone:478-352-4304
Practice Address - Fax:478-975-6652
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOUSTON PHYSICIAN SPECIALISTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-03
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty