Provider Demographics
NPI:1407849946
Name:DARMADI, DANIEL H (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:H
Last Name:DARMADI
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 1:444 FM 1959 RD
Mailing Address - Street 2:STE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-5416
Mailing Address - Country:US
Mailing Address - Phone:281-481-9400
Mailing Address - Fax:281-481-9490
Practice Address - Street 1:444 FM 1959 RD
Practice Address - Street 2:STE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-5416
Practice Address - Country:US
Practice Address - Phone:281-481-9400
Practice Address - Fax:281-481-9490
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2212207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B8120OtherBCBS
TX145815001Medicaid
TX100016375OtherRAILROAD MEDICARE
TX8B8120OtherBCBS
TXG43522Medicare UPIN