Provider Demographics
NPI:1689692618
Name:GEIS, CHAMAIPORN V (NP, MSN)
Entity Type:Individual
Prefix:MRS
First Name:CHAMAIPORN
Middle Name:V
Last Name:GEIS
Suffix:
Gender:F
Credentials:NP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GREENWAY PLZ STE 2950
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-0924
Mailing Address - Country:US
Mailing Address - Phone:713-935-0333
Mailing Address - Fax:
Practice Address - Street 1:530 HIGHWAY 6 S
Practice Address - Street 2:REDICLINIC
Practice Address - City:SUGARLAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-325-0311
Practice Address - Fax:281-325-0312
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX602290363LA2200X, 363LF0000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y3603 BCBSTXOtherBCBSTX
8F6841Medicare PIN
8L7708Medicare PIN
8L7706Medicare PIN
8L7707Medicare PIN
TX8Y3603 BCBSTXOtherBCBSTX