Provider Demographics
NPI:1326235359
Name:DEOMAMPO, LOUISEA MARIE RAYMUN BONOAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUISEA MARIE RAYMUN
Middle Name:BONOAN
Last Name:DEOMAMPO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:UNIVERSITY OF TEXAS MEDICAL BRANCH- RADIOLOGY
Mailing Address - Street 2:301 UNIVERSITY BOULEVARD ROUTE 0709
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0709
Mailing Address - Country:US
Mailing Address - Phone:409-772-2496
Mailing Address - Fax:409-747-2825
Practice Address - Street 1:UNIVERSITY OF TEXAS MEDICAL BRANCH- RADIOLOGY
Practice Address - Street 2:301 UNIVERSITY BOULEVARD ROUTE 0709
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0709
Practice Address - Country:US
Practice Address - Phone:409-772-2496
Practice Address - Fax:409-747-2825
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
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Provider Licenses
StateLicense IDTaxonomies
TXTP100268462085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging