Provider Demographics
NPI:1558875898
Name:TEXAS PERINATOLOGY
Entity Type:Organization
Organization Name:TEXAS PERINATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:BABU
Authorized Official - Last Name:TAM TAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-982-3536
Mailing Address - Street 1:413 JACKSON HILL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-7409
Mailing Address - Country:US
Mailing Address - Phone:720-982-3536
Mailing Address - Fax:
Practice Address - Street 1:413 JACKSON HILL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-7409
Practice Address - Country:US
Practice Address - Phone:720-982-3536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-23
Last Update Date:2017-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty