# NORTHWEST INFECTIOUS DISEASE AND TRAVEL MEDICINE, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861496309
- **Authorized official:** MR. PORNTHEP WATTANAMANO M.D. (PRESIDENT)
- **Authorized official phone:** (713) 384-3229

## Contact information

- **Practice address:** 5509 CORNISH ST., HOUSTON, TX 77007-4303
- **Practice address phone:** (713) 831-5089
- **Practice address fax:** (713) 360-7715
- **Mailing address:** 5509 CORNISH ST., HOUSTON, TX 77007-4303
- **Mailing address phone:** (713) 831-5089
- **Mailing address fax:** (713) 360-7715

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | — | TX | Yes |

## Other

- **Enumeration date:** 06/13/2005
- **Last updated:** 07/21/2022