Provider Demographics
NPI:1184930018
Name:UMMAT, MONIKA (MD)
Entity type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:
Last Name:UMMAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 LA CONCHA LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1809
Mailing Address - Country:US
Mailing Address - Phone:832-831-7800
Mailing Address - Fax:832-831-7801
Practice Address - Street 1:1313 LA CONCHA LN STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1809
Practice Address - Country:US
Practice Address - Phone:832-831-7800
Practice Address - Fax:832-831-7801
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7589208000000X, 2084N0400X, 2084N0402X, 2084N0600X
174400000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3353765Medicaid