Individual
DR. TAKEHISA IKEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1140 BUSINESS CENTER DR STE 300, HOUSTON, TX 77043-2742
(713) 464-9774
(713) 464-9771
Mailing address
PO BOX 3278, PEARLAND, TX 77588-3278
(713) 464-9776
(713) 464-9771
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
N0117
TX
2080P0208X
Pediatric Infectious Diseases Physician
Primary
N0117
TX
208M00000X
Hospitalist Physician
N0117
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205456101
—
TX
Enumeration date
07/21/2008
Last updated
10/11/2018
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