Provider Demographics
NPI:1578097036
Name:TOMAJ, ALBAN
Entity Type:Individual
Prefix:
First Name:ALBAN
Middle Name:
Last Name:TOMAJ
Suffix:
Gender:M
Credentials:
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
Mailing Address - Street 2:SUITE MSB 3.151
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-5800
Mailing Address - Fax:713-500-5805
Practice Address - Street 1:2001 N JEFFERSON AVE STE 300
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2375
Practice Address - Country:US
Practice Address - Phone:903-572-9823
Practice Address - Fax:903-572-4812
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXS5794208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program