Individual
SHIBU OOMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4708 ALLIANCE BLVD, SUITE 300, BAYLOR MEDICAL PLAZA 1, PLANO, TX 75093-5340
(972) 758-6000
(972) 758-6001
Mailing address
4708 ALLIANCE BLVD, SUITE 300, BAYLOR MEDICAL PLAZA 1, PLANO, TX 75093-5340
(972) 758-6000
(972) 758-6001
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
226586
NY
207RG0100X
Gastroenterology Physician
Primary
M7492
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189217601
—
TX
05
—
189217602
—
TX
01
—
8AG041
BCBS
TX
Enumeration date
06/21/2006
Last updated
07/24/2008
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