Dr. John Mathew Poothullil
Allergist & Immunologist
201 Oak Dr S Suite 106
Lake Jackson
, Texas 77566-5676
Dr. John Mathew Poothullil
Allergist & Immunologist
201 Oak Dr S Suite 106
Lake Jackson
, Texas 77566-5676
(979) 297-5919
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About
Features
Specialties
- Allergist & Immunologist
Languages spoken
- English
Location
First Address
- Dr. John Mathew Poothullil
- 201 Oak Dr S Suite 106
- Lake Jackson, TX
- Zip : 77566-5676
- Fax : (979) 297-5919
- Phone : (979) 297-8006
Second Address
- Dr. John Mathew Poothullil
- 201 Oak Dr S Suite 106
- Lake Jackson, TX
- Zip : 77566-5676
- Fax : (979) 297-5919
- Phone : (979) 297-8006
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207K00000X | Allergist & Immunologist | E6880 | TX |
National Provider Identifier
| NPI | 1134102528 |
|---|---|
| Provider Name | Dr. John Mathew Poothullil |
| First Address | Lake Jackson, TX 77566-5676 |
| Second Address | Lake Jackson, TX 77566-5676 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/11/2005 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 02914600-01 | CIGNA (01) | TX |
| 02914600-13 | CIGNA HMO (01) | TX |
| 02914600-14 | CIGNA SELECT (01) | TX |
| 10020011 | AMERIKIDS (01) | TX |
| 2225592 | BCBS BLUE LINK (01) | TX |
| B25592 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.