Provider Demographics
NPI:1275568420
Name:TOMM, KARL E (MD)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:E
Last Name:TOMM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6560 FANNIN
Mailing Address - Street 2:#1846
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-797-1303
Mailing Address - Fax:713-790-0931
Practice Address - Street 1:6560 FANNIN
Practice Address - Street 2:#1846
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-797-1303
Practice Address - Fax:713-795-9805
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8620208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B27025Medicare UPIN
TX00U37QMedicare ID - Type Unspecified