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General NPI Number Information
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NPI Number | 1184829764
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Entity Type | Individual
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Provider Name | SMITHA ELIZABETH OOMMEN MD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 3560 DELAWARE ST STE 1104
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City | BEAUMONT
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State | TX
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Zip | 77706-3000
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Country | US
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Telephone | 409-347-8870
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Fax | 409-554-0016
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Provider Business Mailing Address
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Address Line | 3560 DELAWARE ST STE 1104
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City | BEAUMONT
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State | TX
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Zip | 77706-3000
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Country | US
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Telephone | 409-347-8870
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Fax | 409-347-8878
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BP1-002628
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | N7853
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License Number State | TX
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