Provider Demographics
NPI:1528602687
Name:OM AASTHA, LLC
Entity Type:Organization
Organization Name:OM AASTHA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:PRANAV
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUKLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-551-3029
Mailing Address - Street 1:1900 NORTH LOOP W STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8110
Mailing Address - Country:US
Mailing Address - Phone:832-551-3029
Mailing Address - Fax:832-629-1182
Practice Address - Street 1:1900 NORTH LOOP W STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8110
Practice Address - Country:US
Practice Address - Phone:832-551-3029
Practice Address - Fax:832-629-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care