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NPI Code Detail

MEDICARE: DR. BIJU OOMMEN M.D.

MEDICARE: DR. BIJU OOMMEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) PhysicianL5863TX

General Provider Information

NPI Number : 1801856240
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BIJU OOMMEN M.D.
Provider Business Mailing Address
First Line : PO BOX 650998
Second Line :
City : DALLAS
State : TX
Zip : 75265-0998
Country : US
Telephone Number : 281-389-0366
Fax Number :
Provider Business Practice Location Address
First Line : 2626 S LOOP W STE 265
Second Line :
City : HOUSTON
State : TX
Zip : 77054-5636
Country : US
Telephone Number : 281-389-0366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2006
Last Update Date : 05/21/2024

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