Provider Demographics
NPI:1841298031
Name:TROUTMAN, TAMMY RENEE (MD)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:RENEE
Last Name:TROUTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:RENEE
Other - Last Name:FEEHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 UNIVERSITY DR E
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-2661
Practice Address - Country:US
Practice Address - Phone:979-207-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT8963208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3814378Medicaid
G51619Medicare UPIN
TN3814371Medicare ID - Type Unspecified