Individual
DR. ANJU ANNIE MAMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 S FRY RD, SUITE 207, KATY, TX 77450-2244
(281) 492-7676
(281) 492-8133
Mailing address
777 S FRY RD, SUITE 207, KATY, TX 77450-2244
(281) 492-7676
(281) 492-8133
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M7397
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236164
—
CT
01
—
010042497CT01
BCS
CT
01
—
042497
CTC
CT
05
—
282923603
—
TX
Enumeration date
03/22/2006
Last updated
07/27/2015
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