Healthcare Provider Details

I. General information

NPI: 1740299254
Provider Name (Legal Business Name): PINKY S TIWARI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6560 FANNIN ST STE 1630
HOUSTON TX
77030-2734
US

IV. Provider business mailing address

6560 FANNIN ST STE 1630
HOUSTON TX
77030-2734
US

V. Phone/Fax

Practice location:
  • Phone: 713-790-1775
  • Fax: 713-790-1605
Mailing address:
  • Phone: 713-790-1775
  • Fax: 713-790-1605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberJ9829
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: