Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | H5596 | TX |
NPI | 1063550374 |
---|---|
Provider Name | Poovamma B Muthappa |
First Address | Houston, TX 77079 |
Second Address | Houston, TX 77079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 06/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
126236203 | (05) | TX |
E51593 | (02) |