Provider Demographics
NPI:1851800080
Name:TEEKAM LOHANO, MD PA
Entity Type:Organization
Organization Name:TEEKAM LOHANO, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TEEKAM
Authorized Official - Middle Name:DAS
Authorized Official - Last Name:LOHANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-527-9800
Mailing Address - Street 1:2400 HIGHWAY 365 STE 107
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-6268
Mailing Address - Country:US
Mailing Address - Phone:409-527-9800
Mailing Address - Fax:409-527-9801
Practice Address - Street 1:2400 HIGHWAY 365 STE 107
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627
Practice Address - Country:US
Practice Address - Phone:409-527-9800
Practice Address - Fax:409-527-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ4181208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX357431101Medicaid