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NPI Code Detail

MEDICARE: SHIVA DARAM M.D.

MEDICARE: SHIVA DARAM M.D.
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
1207YP0228XPediatric Otolaryngology Physician036.145158IL
2390200000XStudent in an Organized Health Care Education/Training Program
3207YP0228XPediatric Otolaryngology PhysicianR2562TX

General Provider Information

NPI Number : 1497199061
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIVA DARAM M.D.
Provider Business Mailing Address
First Line : 6431 FANNIN ST
Second Line : MSB 5.036
City : HOUSTON
State : TX
Zip : 77030
Country : US
Telephone Number : 713-500-6636
Fax Number :
Provider Business Practice Location Address
First Line : 6400 FANNIN ST STE 2700
Second Line :
City : HOUSTON
State : TX
Zip : 77030-1539
Country : US
Telephone Number : 713-486-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2013
Last Update Date : 12/08/2022

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