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General NPI Number Information
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NPI Number | 1639286529
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Entity Type | Organization
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Legal Business Name | BIJU OOMMEN, M.D., P.A.
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 06/20/2017
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Provider Practice Location Address
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Address Line | 815 S VOSS RD
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City | HOUSTON
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State | TX
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Zip | 77057-1031
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Country | US
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Telephone | 281-389-0366
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Fax | 281-596-4357
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Provider Business Mailing Address
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Address Line | 8307 KNIGHT RD
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City | HOUSTON
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State | TX
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Zip | 77054-3905
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Country | US
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Telephone | 713-796-9955
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Fax | 713-796-9779
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Authorized Official
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Title or Position | OWNER
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Name | DR. BIJU OOMMEN
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Credential | M.D.
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Telephone | 281-389-0366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | L5863
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License Number State | TX
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