MEDICARE: DR. KARYN-ANNE B. CUMBERBATCH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	J1642	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00369794	OTHER	TX	TRAVELER'S MEDICARE #
6	P01090446	OTHER	TX	RAILROAD MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	J1642	OTHER	TX	TX MEDICAL LICENSE
3	8W5590	OTHER	TX	BC/BS TX #
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	8DE524	OTHER	TX	BC/BS #

General Provider Information

NPI Number	:	1073618344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARYN-ANNE B. CUMBERBATCH MD

Provider Business Mailing Address
First Line	:	PO BOX 392556
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-9556
Country	:	US
Telephone Number	:	713-806-1855
Fax Number	:	979-532-6790

Provider Business Practice Location Address
First Line	:	3640 HAMPTON DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459
Country	:	US
Telephone Number	:	713-806-1855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	06/14/2019

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