MEDICARE: SHANMUGAM UTHAMALINGAM 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	207RC0000X	Cardiovascular Disease Physician	L9528	TX

General Provider Information

NPI Number	:	1629039904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANMUGAM UTHAMALINGAM MD

Provider Business Mailing Address
First Line	:	4501 MAGNOLIA COVE DR STE 201
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77345-2252
Country	:	US
Telephone Number	:	936-270-3933
Fax Number	:	713-791-5134

Provider Business Practice Location Address
First Line	:	4501 MAGNOLIA COVE DR STE 201
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77345-2252
Country	:	US
Telephone Number	:	936-270-3933
Fax Number	:	713-791-5134

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	05/05/2023

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