Provider Demographics
NPI:1417079369
Name:WATTS, TAMMARA L (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:TAMMARA
Middle Name:L
Last Name:WATTS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0521
Mailing Address - Country:US
Mailing Address - Phone:409-772-3009
Mailing Address - Fax:409-772-1715
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0521
Practice Address - Country:US
Practice Address - Phone:409-772-3009
Practice Address - Fax:409-772-1715
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43260207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology