Provider Demographics
NPI:1851466304
Name:LILETTE DAUMAS MD PA
Entity Type:Organization
Organization Name:LILETTE DAUMAS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-455-1306
Mailing Address - Street 1:12755 WOODFOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-2737
Mailing Address - Country:US
Mailing Address - Phone:713-455-1306
Mailing Address - Fax:713-455-9560
Practice Address - Street 1:12755 WOODFOREST BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-2737
Practice Address - Country:US
Practice Address - Phone:713-455-1306
Practice Address - Fax:713-455-9560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3240207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTIN
TX00304UMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER