Healthcare Provider Details

I. General information

NPI: 1861750044
Provider Name (Legal Business Name): KAROMIBAL MEJIA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 MAIN ST STE 301
RICHMOND TX
77469-3230
US

IV. Provider business mailing address

1601 MAIN ST STE 301
RICHMOND TX
77469-3230
US

V. Phone/Fax

Practice location:
  • Phone: 832-945-3181
  • Fax: 281-781-2489
Mailing address:
  • Phone: 832-945-3181
  • Fax: 281-781-2489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberS1183
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberS1183
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: