1447237243 NPI number — DR. PRAMODA KUMAR MOHAPATRA M.D.

Table of content: DR. PRAMODA KUMAR MOHAPATRA M.D. (NPI 1447237243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447237243 NPI number — DR. PRAMODA KUMAR MOHAPATRA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOHAPATRA
Provider First Name:
PRAMODA
Provider Middle Name:
KUMAR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447237243
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11511 SHADOW CREEK PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEARLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77584-7298
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-442-0000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 FM 1488 ROAD
Provider Second Line Business Practice Location Address:
HEALTH POINT HEMPSTEAD
Provider Business Practice Location Address City Name:
HEMPSTEAD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77445-9998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-826-8200
Provider Business Practice Location Address Fax Number:
979-826-8210
Provider Enumeration Date:
12/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  L7280 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1635237-08 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3410037-01 . This is a "TPI HEALTH POINT HEMPSTEAD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: L7280 . This is a "STATE LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1649689274 . This is a "HEALTH POINT HEMPSTEAD - FACILITY NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1635211001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1821185299 . This is a "BVCAA, INC. - AGENCY NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 74-1868 . This is a "PTAN HEALTH POINT HEMPSTEAD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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