Provider Demographics
NPI:1487005146
Name:CHERIAN, ELENA THAMPY (MBBS)
Entity Type:Individual
Prefix:
First Name:ELENA THAMPY
Middle Name:
Last Name:CHERIAN
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6431 FANNIN ST STE MSB 5104
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-6643
Mailing Address - Fax:713-500-6647
Practice Address - Street 1:11476 SPACE CENTER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77059-3656
Practice Address - Country:US
Practice Address - Phone:713-486-6325
Practice Address - Fax:713-486-6324
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10056625207R00000X
TXT1036207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine