Individual
DR. MICHIAKI IMAMURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
6621 FANNIN STREET, WT-19345H, HOUSTON, TX 77030-2399
(832) 826-1929
(832) 825-1904
Mailing address
6621 FANNIN STREET, WT-19345H, HOUSTON, TX 77030-2399
(832) 826-1929
(832) 825-1904
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
E-3474
AR
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
45912
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
E-3474
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02100031400
QUALCHOICE
AR
05
—
148197001
—
AR
Enumeration date
09/27/2006
Last updated
03/23/2018
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