Provider Demographics
NPI:1033449970
Name:HOUSTON BAY AREA FERTILITY CENTER PA
Entity Type:Organization
Organization Name:HOUSTON BAY AREA FERTILITY CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUBAI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-632-2653
Mailing Address - Street 1:PO BOX 57459
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-7459
Mailing Address - Country:US
Mailing Address - Phone:832-632-2653
Mailing Address - Fax:832-632-2984
Practice Address - Street 1:9 PROFESSIONAL PARK DR
Practice Address - Street 2:SUITE C
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4142
Practice Address - Country:US
Practice Address - Phone:832-632-2653
Practice Address - Fax:832-632-2984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-26
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDQ2354OtherRRMEDICARE
TX209023501Medicaid
TX0024TBOtherBCBSTX
TX0024TBOtherBCBSTX
TX209023501Medicaid