Provider Demographics
NPI:1063511608
Name:HINGORANI, RISHI SHYAM (DO)
Entity Type:Individual
Prefix:DR
First Name:RISHI
Middle Name:SHYAM
Last Name:HINGORANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 CYPRESS STATION DR
Mailing Address - Street 2:STE B-4
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2505
Mailing Address - Country:US
Mailing Address - Phone:281-440-1400
Mailing Address - Fax:281-245-0633
Practice Address - Street 1:1125 CYPRESS STATION DR
Practice Address - Street 2:STE B-4
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3054
Practice Address - Country:US
Practice Address - Phone:281-440-1400
Practice Address - Fax:281-245-0633
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168656003Medicaid
TX8X1320OtherBLUE CROSS/BLUE SHIELD
TX168656003Medicaid
TX8X1320OtherBLUE CROSS/BLUE SHIELD