Healthcare Provider Details

I. General information

NPI: 1316827165
Provider Name (Legal Business Name): LIFESCULPT UROGYNECOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18300 KATY FWY STE 565
HOUSTON TX
77094-1536
US

IV. Provider business mailing address

18300 KATY FWY STE 565
HOUSTON TX
77094-1536
US

V. Phone/Fax

Practice location:
  • Phone: 281-717-4003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA PRAMUDJI
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 713-206-1378