Provider Demographics
NPI:1023364890
Name:VAIKOM HOUSE, ASWATHY KUMAR (MD MBBS)
Entity Type:Individual
Prefix:
First Name:ASWATHY
Middle Name:KUMAR
Last Name:VAIKOM HOUSE
Suffix:
Gender:F
Credentials:MD MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 EVERETT DR # NP2350
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5047
Mailing Address - Country:US
Mailing Address - Phone:405-271-4411
Mailing Address - Fax:
Practice Address - Street 1:OU CHILDRENS HOSPITAL
Practice Address - Street 2:1200 EVERETT DR.
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-271-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NETEP6871208000000X
OK338332080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics